Clinically diagnosed insomnia and risk of all-cause and diagnosis-specific disability pension: a nationwide cohort study.
Clinically diagnosed insomnia and risk of all-cause and diagnosis-specific disability pension: a nationwide cohort study.
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DOI：
10.1155/2013/209832
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发表时间：
2013
期刊：
影响因子：
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通讯作者：
Akerstedt T
中科院分区：
文献类型：
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作者：
Jansson C;Alexanderson K;Kecklund G;Akerstedt T
背景失眠和残疾养老金是主要的健康问题，但很少有基于人口的研究探讨了失眠和残疾养老金风险之间的关系。方法.我们进行了一项前瞻性的全国性队列研究，该研究基于瑞典基于人口的登记册，包括2004/2005年12月31日居住在瑞典的所有5，028，922名年龄在17-64岁之间的人，没有残疾或老年养老金。将2000/2001-2005年期间至少有一次入院/专家就诊诊断为启动和维持睡眠障碍（失眠症）（ICD-10：G47.0）的患者与没有此类住院/门诊治疗的患者进行比较。2006年至2010年，对全因和特定诊断事故残疾养恤金进行了跟踪。通过考克斯回归估计发生率比（IRR）和95%置信区间（CI）。结果在调整了既往病假、社会人口因素和住院/专科门诊护理的模型中，观察到失眠与全因残疾养老金（IRR 1.35，95%CI 1.09-1.67）和精神病诊断所致残疾养老金（IRR 1.86，95%CI 1.38-2.50）风险增加之间的相关性。在进一步调整失眠药物后，这些关联消失了。没有观察到失眠与癌症、循环系统或肌肉骨骼疾病导致的残疾养老金风险之间的关联。结论住院似乎与全因残疾养恤金和精神病诊断残疾养恤金呈正相关。
Background. Insomnia and disability pension are major health problems, but few population-based studies have examined the association between insomnia and risk of disability pension. Methods. We conducted a prospective nationwide cohort study based on Swedish population-based registers including all 5,028,922 individuals living in Sweden on December 31, 2004/2005, aged 17–64 years, and not on disability or old age pension. Those having at least one admission/specialist visit with a diagnosis of disorders of initiating and maintaining sleep (insomnias) (ICD-10: G47.0) during 2000/2001–2005 were compared to those with no such inpatient/outpatient care. All-cause and diagnosis-specific incident disability pension were followed from 2006 to 2010. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were estimated by Cox regression. Results. In models adjusted for prior sickness absence, sociodemographic factors, and inpatient/specialized outpatient care, associations between insomnia and increased risks of all-cause disability pension (IRR 1.35, 95% CI 1.09–1.67) and disability pension due to mental diagnoses (IRR 1.86, 95% CI 1.38–2.50) were observed. After further adjustment for insomnia medications these associations disappeared. No associations between insomnia and risk of disability pension due to cancer, circulatory, or musculoskeletal diagnoses were observed. Conclusion. Insomnia seems to be positively associated with all-cause disability pension and disability pension due to mental diagnoses.