Department of Exercise Health Science, National Taiwan University of Sport, Taichung City, Taiwan; Department of Epidemiology and Public Health, University College London, London, UK.
Department of Epidemiology and Public Health, University College London, London, UK.
Sleep Med. 2017 Feb;30:189-194. doi: 10.1016/j.sleep.2016.06.040. Epub 2016 Nov 25.
This study was designed to examine the independent and combined associations of physical activity and smoking on the incidence of doctor-diagnosed insomnia using a nationally representative sample over seven years, taking into account other relevant covariates.
Participants aged 18 years or older in the 2005 Taiwan National Health Interview Survey (NHIS) with links to National Health Insurance (NHI) claim data between 2005 and 2012 and without diagnosed insomnia before 2005, were selected into this study (n = 12,728). Participants were classified as having insomnia with International Classification of Diseases, Ninth Revision (ICD-9) CM codes 307.41, 307.42, or 780.52. Self-reported smoking status and frequency, duration, and types of leisure-time and non-leisure-time physical activities were collected. Metabolic equivalent (MET) intensity levels for each activity were assigned, and weekly energy expenditure of each activity was calculated and summed.
Inactive participants had a higher risk of incident insomnia [hazard ratio (HR) = 1.22, 95% confidence interval (CI) = 1.06-1.42, p = 0.007] than the active group, and ever-smokers were more likely to have incident insomnia than never smokers (HR = 1.45, 95% CI = 1.20-1.76, p < 0.001). Compared with the nonsmoker/active group, the ever-smoker/inactive group had a higher risk of incident insomnia (HR = 1.78, 95% CI = 1.41-2.25, p < 0.001). Sensitivity analyses excluding individuals diagnosed with other sleep disorders or mental disorders yielded similar results, with the ever-smoker/inactive group having the highest risk of insomnia.
Inactive adults and smokers are at higher risk for incident insomnia, highlighting the importance of a healthy lifestyle and pointing to strategies such as encouraging smoking cessation and physical activity to avoid insomnia among adults.
本研究旨在利用一个具有代表性的七年全国样本，考虑到其他相关协变量，研究体力活动和吸烟对医生诊断的失眠发病率的独立和联合影响。
本研究选取了 2005 年台湾全国健康访谈调查（NHIS）中年龄在 18 岁或以上的成年人，这些人在 2005 年至 2012 年期间与国家健康保险（NHI）索赔数据相关联，且在 2005 年之前没有被诊断为失眠，并链接到 2005 年的全国健康访谈调查（NHIS）中，这些人被纳入本研究（n=12728）。参与者被归类为患有国际疾病分类，第九修订版（ICD-9）CM 代码 307.41、307.42 或 780.52 的失眠症。收集了自我报告的吸烟状况和频率、持续时间以及休闲时间和非休闲时间体力活动的类型。为每项活动分配代谢当量（MET）强度水平，并计算和汇总每项活动的每周能量消耗。
不活跃的参与者发生失眠的风险较高[风险比（HR）=1.22，95%置信区间（CI）=1.06-1.42，p=0.007]，而吸烟者比从不吸烟者更容易发生失眠（HR=1.45，95%CI=1.20-1.76，p<0.001）。与不吸烟者/活跃组相比，曾吸烟者/不活跃组发生失眠的风险更高（HR=1.78，95%CI=1.41-2.25，p<0.001）。排除诊断患有其他睡眠障碍或精神障碍的个体的敏感性分析得出了类似的结果，其中曾吸烟者/不活跃组发生失眠的风险最高。
不活跃的成年人和吸烟者发生失眠的风险更高，这突出了健康生活方式的重要性，并指出了鼓励戒烟和体力活动等策略，以避免成年人失眠。
