Study Finds Insomnia Associated with Increased Risk of Heart Disease, Stroke

New data is raising concern over the impact insomnia can have on other areas of a person’s health.

A study from China has found people with trouble sleeping could be at an increased risk for stroke, heart attack, or other cerebrovascular or cardiovascular diseases.

In an effort to examine potential associations between individual insomnia symptoms with risk of incident cardiovascular and cerebrovascular diseases, investigators conducted a prospective cohort study of more than 400,00 adults across China. The China Kadoorie Biobank included adults from 30 to 79 years of age without a history of stroke, coronary heart disease, and cancer at baseline.

Assessment of insomnia symptoms occurred through use of a baseline survey that included question pertaining to difficulties in initiating or maintaining sleep, early morning awakening, and daytime dysfunction. Patients who reported 1 or more of the 3 symptoms for at least 3 days per week were classified by investigators as having insomnia symptoms. Investigators noted incidences of cardiovascular and cerebrovascular diseases were obtained through disease registries and national health insurance databases until 2016.

A cohort of 487,200 participants was identified for analysis. Of this cohort, 11.3% reporting having difficulty in maintaining or initiating sleep(DIMS), 10.4% reported having early morning awakening(EMA), and 2.2% reported having daytime dysfunction(DDF). Investigators pointed out participants with DIMS, EMA, or DDF were more likely to be older, female, not married, and from a rural area than their counterparts without specific insomnia symptoms.

During the follow-up period, which had a mean length of 9.6 years, a total of 130,032 cases of cardiovascular and cerebrovascular disease, 40,348 cases of ischemic heart disease, and 45,316 cases of stroke incidence were documented. In an analyses adjusting for potential confounders, DIMS (1.09), EMA (1.07), and DDF (1.13) were all associated with increased risks of total cardiovascular and cerebrovascular disease (95% CI, all).

Additional analyses revealed patients with DIMS were 9% more likely to develop heart disease or have a stroke than those without and 32% of patients with DIMS suffered a stroke or heart disease compared to 26% of people without the symptom.

"These results suggest that if we can target people who are having trouble sleeping with behavioral therapies, it's possible that we could reduce the number of cases of stroke, heart attack and other diseases later down the line," said investigator Liming Li, MD, of Peking University in Beijing, China, in a press release.

This study, titled “Insomnia symptoms and risk of cardiovascular diseases among 0.5 million adults,” was published online in Neurology.