J Sleep Res. 2014 Apr;23(2):124-32. doi: 10.1111/jsr.12102.
Insomnia co-occurs with many health problems, but less is known about the prospective associations. The aim of the current study was to investigate if insomnia predicts cumulative incidence of mental and physical conditions. Prospective population-based data from the two last Nord-Trøndelag Health Studies (HUNT2 in 1995–97 and HUNT3 in 2006–08), comprising 24 715 people in the working population, were used to study insomnia as a risk factor for incidence of physical and mental conditions. Insomnia was defined according to the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Insomnia at HUNT2 was a significant risk factor for incidence of a range of both mental and physical conditions at HUNT3 11 years later. Most effects were only slightly attenuated when adjusting for confounding factors, and insomnia remained a significant risk factor for the following conditions in the adjusted analyses: depression [odds ratio (OR): 2.38, 95% confidence interval (CI): 1.91–2.98], anxiety (OR: 2.08, 95% CI: 1.63–2.64), fibromyalgia (OR: 2.05, 95% CI: 1.51–2.79), rheumatoidarthritis (OR: 1.87, 95% CI: 1.29–2.52), whiplash (OR: 1.71, 95% CI: 1.21–2.41), arthrosis (OR: 1.68, 95% CI: 1.43–1.98), osteoporosis (OR:1.52, 95% CI: 1.14–2.01, headache (OR: 1.50, 95% CI: 1.16–1.95,asthma (OR: 1.47, 95% CI: 1.16–1.86 and myocardial infarction (OR:1.46, 95% CI: 1.06–2.00). Insomnia was also associated significantly with incidence of angina, hypertension, obesity and stroke in the crude analyses, but not after adjusting for confounders. We conclude that insomnia predicts cumulative incidence of several physical and mental conditions. These results may have important clinical implications, and whether or not treatment of insomnia would have a preventive value for both physical and mental conditions should be studied further.
失眠与许多健康问题同时发生,但人们对其前瞻性关联知之甚少。本研究的目的是调查失眠是否可以预测精神和身体疾病的累积发病率。本研究使用了来自前两次北特伦德拉格健康研究(1995-1997 年的 HUNT2 和 2006-2008 年的 HUNT3)的前瞻性人群数据,该数据包含了 24715 名工作人群,用于研究失眠作为身体和精神疾病发病的危险因素。根据《精神障碍诊断与统计手册》第 4 版(DSM-IV)定义失眠。HUNT2 时的失眠是 11 年后 HUNT3 时多种精神和身体疾病发病的显著危险因素。调整混杂因素后,大多数影响略有减弱,调整分析中失眠仍然是以下疾病的显著危险因素:抑郁症[比值比(OR):2.38,95%置信区间(CI):1.91-2.98]、焦虑症(OR:2.08,95%CI:1.63-2.64)、纤维肌痛(OR:2.05,95%CI:1.51-2.79)、类风湿关节炎(OR:1.87,95%CI:1.29-2.52)、挥鞭伤(OR:1.71,95%CI:1.21-2.41)、关节炎(OR:1.68,95%CI:1.43-1.98)、骨质疏松症(OR:1.52,95%CI:1.14-2.01)、头痛(OR:1.50,95%CI:1.16-1.95)、哮喘(OR:1.47,95%CI:1.16-1.86)和心肌梗死(OR:1.46,95%CI:1.06-2.00)。失眠与心绞痛、高血压、肥胖和中风的发病率也有显著相关性,但在调整混杂因素后则没有。我们得出结论,失眠可预测多种身体和精神疾病的累积发病率。这些结果可能具有重要的临床意义,是否治疗失眠对身体和精神疾病都有预防价值,这值得进一步研究。