Insomnia and daytime sleepiness predict 20-year mortality in older male adults: data from a population-based study

Merlino, Giovanni; Lorenzut, Simone; Gigli, Gian Luigi; Negro, Ilaria Del; Tereshko, Yan; Smeralda, Carmelo; Piani, Antonella; Valente, Mariarosaria

doi:10.1016/j.sleep.2020.06.025

Cited by 19 publications

(6 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“… 32 Moreover, EDS has also been associated with 23% increase of all-cause mortality in a recent meta-analysis. 19 Additionally, similar to the association between EDS and all-cause mortality, 33 the association between EDS and cardiovascular mortality appeared stronger in males than females although no interaction between sex and EDS was observed.…”

Section: Discussionmentioning

confidence: 68%

Excessive Daytime Sleepiness and Cardiovascular Mortality in US Adults: A NHANES 2005–2008 Follow-Up Study

Li¹,

Covassin²,

Bock³

et al. 2021

NSS

View full text Add to dashboard Cite

Purpose: Excessive daytime sleepiness is highly prevalent and has been associated with increased risk of cardiovascular diseases, but evidence for its association with cardiovascular mortality is limited and inconsistent. We aimed to determine whether excessive daytime sleepiness is independently associated with cardiovascular mortality in general adult population. Patients and Methods: A prospective study of 10,330 adult participants (aged ≥20 years) from National Health and Nutrition Examination Survey (NHANES) 2005-2006 and 2007-2008 was followed up until December 31st, 2015. Excessive daytime sleepiness was defined as the self-reported feeling of being overly sleepy often or always during the day. Cox proportional hazard ratios (HRs) with 95% confidence interval (CI) were estimated to assess risk for cardiovascular mortality. Results: A total of 10,330 participants with mean age of 47.3 years (95% CI, 46.0 to 48.1) were included in this analysis. Approximately, 18.5% of US adults reported excessive daytime sleepiness. Over a mean follow-up of 8.3 years, 262 cardiovascular deaths occurred. Participants with excessive daytime sleepiness had 2.85-times greater risk (95% CI, 1.33-6.09) of cardiovascular death than those without daytime sleepiness in multivariable analysis corrected for sociodemographic factors, comorbidities and cardiovascular risk factors including depression. Further adjustment for self-reported sleep disorders and sleep duration only slightly attenuated this association (HR, 2.55; 95% CI, 1. 23-5.27). No interactions between excessive daytime sleepiness and age, sex or cardiovascular disease at study entry were observed (all Ps>0.05). Conclusion: Excessive daytime sleepiness is highly prevalent among US adults and is independently associated with an approximately two-and-a-half-fold increased risk of cardiovascular mortality in a large national sample. Screening for excessive daytime sleepiness may be a simple and cost-effective tool for identifying individuals at high risk of cardiovascular death.

show abstract

Section: Discussionmentioning

confidence: 68%

Excessive Daytime Sleepiness and Cardiovascular Mortality in US Adults: A NHANES 2005–2008 Follow-Up Study

Li¹,

Covassin²,

Bock³

et al. 2021

NSS

View full text Add to dashboard Cite

show abstract

“…Evening chronotype has also been associated with elevated levels of c-reactive protein (CRP) [42], which, in turn, has been associated with immunosuppression and poor overall survival in patients with melanoma receiving ICIs [43]. Additionally, other have shown prolonged sleep onset latency (an indicator of insomnia) is associated with severe burden of health conditions (including all-cause mortality) and, in particular, cancer severity [36,[44][45][46][47].…”

Section: Discussionmentioning

confidence: 99%

Associating sleep problems with advanced cancer diagnosis, and immune checkpoint treatment outcomes: a pilot study

Sillah

Peters

Watson

et al. 2022

Support Care Cancer

View full text Add to dashboard Cite

Background Sleep problems (SP) are common in cancer patients but have not been previously assessed in patients receiving immune checkpoint inhibitors (ICI). Methods We collected questionnaire data on sleep apnea risk, insomnia, and general sleep patterns. We used an adjusted multivariate Poisson regression to calculate prevalence ratios (PRs) and associated 95% confidence intervals (CIs) for associations between these SP and metastatic versus localized cancer stage (M1 vs. M0), and adjusted logistic regression models to calculate ORs for associations between SP with the number of ICI infusions completed (6 + vs. < 6). Results Among 32 patients who received ICI treatment, the prevalence of low, intermediate, and high-risk OSA risk was 36%, 42%, and 21%, respectively. Overall, 58% of participants reported clinically significant insomnia. We did not find a significant association between intermediate or high risk OSA (vs. low risk) and metastatic cancer status ( PR = 1.01 (95% CI : 0.28, 3.67)). Patients in the cohort who reported taking > 15 min to fall asleep were 3.6 times more likely to be diagnosed with metastatic cancer compared to those reporting shorter sleep latency (95% CI (1.74, 7.35)). We did not find a significant association between SP and number of ICI infusions completed. Conclusion Our data associating sleep apnea risk, insomnia, and sleep patterns with more advanced cancer encourages further exploration in larger-scale observational studies and suggests interventional clinical trials focused on sleep quality improvement that could result in better outcomes for these patients. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-022-06825-w.

show abstract

“…Both insomnia disorder and EDS predict long-term mortality in the elderly, as these conditions can alter different human systems producing metabolic, endocrine, and immune dysregulation [ 10 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

A State-of-Art Review of the Vicious Circle of Sleep Disorders, Diabetes and Neurodegeneration Involving Metabolism and Microbiota Alterations

Versace,

Pellitteri,

Sperotto

et al. 2023

IJMS

View full text Add to dashboard Cite

In the context of neurodegenerative disorders, cognitive decline is frequently reported in older population. Recently, numerous metabolic pathways have been implicated in neurodegeneration, including signaling disruption of insulin and other glucose-regulating hormones. In fact, Alzheimer’s disease has now been considered as “type-3 diabetes”. In this review, we tried to clarify the role of sleep impairment as the third major player in the complex relationship between metabolic and neurodegenerative diseases. Altered sleep may trigger or perpetuate these vicious mechanisms, leading to the development of both dementia and type 2 diabetes mellitus. Finally, we analyzed these reciprocal interactions considering the emerging role of the gut microbiota in modulating the same processes. Conditions of dysbiosis have been linked to circadian rhythm disruption, metabolic alterations, and release of neurotoxic products, all contributing to neurodegeneration. In a future prospective, gut microbiota could provide a major contribution in explaining the tangled relationship between sleep disorders, dementia and diabetes.

show abstract

Insomnia and daytime sleepiness predict 20-year mortality in older male adults: data from a population-based study

Cited by 19 publications

References 37 publications

Excessive Daytime Sleepiness and Cardiovascular Mortality in US Adults: A NHANES 2005–2008 Follow-Up Study

Excessive Daytime Sleepiness and Cardiovascular Mortality in US Adults: A NHANES 2005–2008 Follow-Up Study

Associating sleep problems with advanced cancer diagnosis, and immune checkpoint treatment outcomes: a pilot study

A State-of-Art Review of the Vicious Circle of Sleep Disorders, Diabetes and Neurodegeneration Involving Metabolism and Microbiota Alterations

Contact Info

Product

Resources

About