Jung Eujene, Ryu Hyun Ho, Kim Sung Wan, Lee Jung Ho, Song Kyoung Jun, Ro Young Sun, Cha Kyoung Chul, Hwang Sung Oh
Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Korea.
Medicine, Chonnam National University, Gwangju, Korea.
PLoS One. 2023 Aug 18;18(8):e0287915. doi: 10.1371/journal.pone.0287915. eCollection 2023.
Insomnia and depression have been known to be risk factors of several diseases, including coronary heart disease. We hypothesized that insomnia affects the out-of-hospital cardiac arrest (OHCA) incidence, and these effects may vary depending on whether it is accompanied by depression. This study aimed to determine the association between insomnia and OHCA incidence and whether the effect of insomnia is influenced by depression.
This prospective multicenter case-control study was performed using Phase II Cardiac Arrest Pursuit Trial with Unique Registration and Epidemiology Surveillance (CAPTURES-II) project database for OHCA cases and community-based controls in Korea. The main exposure was history of insomnia. We conducted conditional logistic regression analysis to estimate the effect of insomnia on the risk of OHCA incidence and performed interaction analysis between insomnia and depression. Finally, subgroup analysis was conducted in the patients with insomnia.
Insomnia was not associated with increased OHCA risk (0.95 [0.64-1.40]). In the interaction analysis, insomnia interacted with depression on OHCA incidence in the young population. Insomnia was associated with significantly higher odds of OHCA incidence (3.65 [1.29-10.33]) in patients with depression than in those without depression (0.84 [0.59-1.17]). In the subgroup analysis, depression increased OHCA incidence only in patients who were not taking insomnia medication (3.66 [1.15-11.66]).
Insomnia with depression is a risk factor for OHCA in the young population. This trend was maintained only in the population not consuming insomnia medication. Early and active medical intervention for patients with insomnia may contribute to lowering the risk of OHCA.
失眠和抑郁一直被认为是包括冠心病在内的多种疾病的危险因素。我们假设失眠会影响院外心脏骤停（OHCA）的发生率，并且这些影响可能因是否伴有抑郁而有所不同。本研究旨在确定失眠与OHCA发生率之间的关联，以及失眠的影响是否受抑郁的影响。
本前瞻性多中心病例对照研究使用了韩国OHCA病例和社区对照的二期心脏骤停追踪试验与独特登记和流行病学监测（CAPTURES-II）项目数据库。主要暴露因素是失眠史。我们进行了条件逻辑回归分析，以估计失眠对OHCA发生率风险的影响，并对失眠和抑郁之间进行了交互分析。最后，对失眠患者进行了亚组分析。
失眠与OHCA风险增加无关（0.95 [0.64 - 1.40]）。在交互分析中，失眠与抑郁在年轻人群的OHCA发生率上存在交互作用。与无抑郁的患者相比，抑郁患者中失眠与OHCA发生率的显著更高的比值比相关（3.65 [1.29 - 10.33]），而无抑郁患者为0.84 [0.59 - 1.17]。在亚组分析中，抑郁仅在未服用失眠药物的患者中增加了OHCA发生率（3.66 [1.15 - 11.66]）。
伴有抑郁的失眠是年轻人群OHCA的危险因素。这种趋势仅在未服用失眠药物的人群中得以维持。对失眠患者进行早期积极的医学干预可能有助于降低OHCA的风险。
