Insomnia symptoms and mortality: a register-linked study among women and men from Finland, Norway and Lithuania
Insomnia symptoms and mortality: a register-linked study among women and men from Finland, Norway and Lithuania
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DOI：
10.1111/jsr.12343
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发表时间：
2016-02-01
影响因子：
4.4
通讯作者：
Rahkonen, Ossi
中科院分区：
文献类型：
--
作者：
Lallukka, Tea;Podlipskyte, Aurelija;Rahkonen, Ossi
关于失眠症状与死亡率之间关联的证据有限且不一致。这项研究检查了来自三个国家的队列中失眠症状与死亡率之间的关联，以显示常见和独特的模式。芬兰队列由赫尔辛基市的 6605 名员工组成，2000 年至 2002 年基准年龄为 40 至 60 岁。挪威队列包括来自挪威西部的 6236 名参与者，1997-1999 年基线年龄为 40-45 岁。立陶宛队列由来自帕兰加市的 1602 名参与者组成，2003 年基线年龄为 35-74 岁。死亡率数据来自截至 2012 年底的芬兰统计局和挪威死因登记处，以及截至 2013 年底的立陶宛地区死亡率登记处。失眠症状包括入睡困难、夜间觉醒和醒来 太早了。协变量包括年龄、婚姻状况、教育程度、吸烟、饮酒、缺乏运动、肥胖、糖尿病、心血管疾病、抑郁、轮班工作、睡眠时间和自评健康状况。使用Cox回归分析。对芬兰（风险比 2.51；95% 置信区间 1.07-5.88）和挪威（风险比 3.42；95% 置信区间 1.03-11.35）队列进行全面调整后，频繁入睡困难与男性全因死亡率相关。在女性和立陶宛，调整后失眠症状与全因死亡率没有统计学显着相关性。总之，入睡困难与挪威和芬兰男性的死亡率有关。失眠症状与死亡率之间关系的变化和异质性凸显，进一步的研究需要区分男性和女性、具体症状和国家背景，并重点关注更慢性的失眠。
Evidence on the association between insomnia symptoms and mortality is limited and inconsistent. This study examined the association between insomnia symptoms and mortality in cohorts from three countries to show common and unique patterns. The Finnish cohort comprised 6605 employees of the City of Helsinki, aged 40-60years at baseline in 2000-2002. The Norwegian cohort included 6236 participants from Western Norway, aged 40-45years at baseline in 1997-1999. The Lithuanian cohort comprised 1602 participants from the City of Palanga, aged 35-74years at baseline in 2003. Mortality data were derived from the Statistics Finland and Norwegian Cause of Death Registry until the end of 2012, and from the Lithuanian Regional Mortality Register until the end of 2013. Insomnia symptoms comprised difficulties initiating sleep, nocturnal awakenings, and waking up too early. Covariates were age, marital status, education, smoking, alcohol, physical inactivity, obesity, diabetes, cardiovascular diseases, depression, shift work, sleep duration, and self-rated health. Cox regression analysis was used. Frequent difficulties initiating sleep were associated with all-cause mortality among men after full adjustments in the Finnish (hazard ratio 2.51; 95% confidence interval 1.07-5.88) and Norwegian (hazard ratio 3.42; 95% confidence interval 1.03-11.35) cohorts. Among women and in Lithuania, insomnia symptoms were not statistically significantly associated with all-cause mortality after adjustments. In conclusion, difficulties initiating sleep were associated with mortality among Norwegian and Finnish men. Variation and heterogeneity in the association between insomnia symptoms and mortality highlights that further research needs to distinguish between men and women, specific symptoms and national contexts, and focus on more chronic insomnia.