Insomnia and mortality: A meta-analysis

Lovato, Nicole; Lack, Leon

doi:10.1016/j.smrv.2018.10.004

Cited by 87 publications

(62 citation statements)

References 57 publications

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“…Overall, insomnia symptoms were not associated with mortality. When we investigated the influence of each insomnia symptom on mortality risk, stratified by sleep duration, both difficulty initiating sleep (HR 1.51, 95% CI No work, n (%) 4496 (28) 4714 (20) 5406 (29) 3804 (18) 5281 (25) 3929 (22) 4581 (19) 4629 (30) 5718 (23) 3492 (25) Current smokers, n (%) Past smokers, n(%) 3980 (25) 6261 (27) 5019 (27) 5222 (25) 5557 (27) 4684 (26) 6089 (26) 4152 (27) 6431 (26) 3810 (27) BMI 2542 (16) 3665 (16) 2758 (15) 3449 (17) 3230 (15) 2977 (16) 4103 (17) 2104 (14) 4238 (17) 1969 (14) Coffee consumption, number of cups daily (SD) 2.9 (1.8) Depression, n (%) 4674 (29) 3954 (17) 5024 (27) 3604 (17) 5213 (25) 3415 (19) 6675 (28) 1953 (13) 6818 (27) 1810 (13) Cancer diagnosis, n (%) (Table 4).…”

Section: Resultsmentioning

confidence: 99%

“…A pooled analysis of 10 studies that evaluated the association between insomnia and total mortality found that individuals who reported difficulty initiating sleep or non-restorative sleep had an increased and dose-dependent risk of all-cause mortality compared to individuals without these symptoms, 12 whereas a recent meta-analysis of 17 studies investigating the relationship between insomnia and mortality found no association. 13 Lovato and Lack conclude from their meta-analysis that there is a need for studies which combine sleep duration and insomnia symptoms. 14 They also point out the need for longer follow-up times (than the mean follow-up duration of 11.6 years in their meta-analysis), and for consideration of daytime symptoms combined with sleep symptoms.…”

Section: Introductionmentioning

confidence: 99%

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<p>Association Between Insomnia And Mortality Is Only Evident Among Long Sleepers</p>

Hedström¹,

Bellocco²,

Ye³

et al. 2019

NSS

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Background: Previous studies investigating the relationship between insomnia and mortality have been inconsistent. Purpose: We aimed to assess whether nocturnal insomnia symptoms and non-restorative sleep are associated with all-cause mortality and whether they modify the associations between short and long sleep duration and all-cause mortality. Patients and methods: The present report is based on a prospective cohort study of 39,139 participants with a mean follow-up time of 19.6 years. Cox proportional hazard models with attained age as timescale were used to estimate overall mortality hazard ratios (HRs) with 95% confidence intervals (CI) for different categories of sleep duration and insomnia symptoms. Results: Both difficulty initiating sleep and daytime sleepiness were independently associated with increased mortality among those with sleep duration of 9 hrs or more (HR 1.51, 95% CI 1.11-2.07 and HR 1.37, 95% CI 1.03-1.82). Mortality increased with increasing severity of difficulties initiating sleep (p for trend 0.04) and daytime sleepiness (p for trend 0.01) among the long sleepers. None of the insomnia symptoms were associated with mortality among those who reported sleep duration of 8 hrs or less. Conclusion: Long sleep in combination with difficulties initiating sleep and daytime sleepiness, possibly due to psychiatric or physical disorders, was thus associated with increased mortality, whereas long sleep without difficulties falling asleep or daytime sleepiness was not associated with mortality. Our study emphasizes the need to take nocturnal insomnia symptoms and daytime sleepiness into consideration when assessing the influence of sleep duration on mortality. Additional research is needed to elucidate the relationship between long sleep, insomnia and related psychiatric and physical disorders.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

<p>Association Between Insomnia And Mortality Is Only Evident Among Long Sleepers</p>

Hedström¹,

Bellocco²,

Ye³

et al. 2019

NSS

View full text Add to dashboard Cite

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“…Firstly, it has been proposed by Bin that much of these evidence points to connecting sleep duration to physical health, and linking sleep quality to mental health. While several meta-analyses have found significant associations between insomnia and mortality and cardiovascular diseases [10][11][12], there remains a dearth of research looking at the relationship between sleep disturbance and other physical diseases, or that between sleep duration and psychiatric diseases. Secondly, Bin also highlighted that sleep duration and quality have been conceptualized so distinctly that many have failed to recognise that they are measures of the same underlying phenomenon [9].…”

Section: Introductionmentioning

confidence: 99%

Independent and combined associations of sleep duration and sleep quality with common physical and mental disorders: Results from a multi-ethnic population-based study

et al. 2020

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Sleep duration and sleep quality are often linked to increased risk of mortality and morbidity. However, national representative data on both sleep duration and sleep quality and their relationship with chronic health problems are rarely available from the same source. This current study aimed to examine the independent and combined associations of sleep duration and sleep quality with physical and mental disorders, using data from the Singapore Mental Health Study 2016. 6,126 residents aged �18years participated in this epidemiological, cross-sectional survey. Sleep measures were assessed using the Pittsburg Sleep Quality Index while lifetime or 12-month medical and psychiatric diagnoses were established using the Composite International Diagnostic Interview 3.0. Both short sleep (<6hrs compared to 7-8hrs) and poor sleep were found to be independently associated with chronic pain, obsessive compulsive disorder and any mental disorder while poor sleep was additionally associated with major depressive disorder, bipolar disorder, generalized anxiety disorder and any physical disorder, when adjusted for confounders. Poor sleep combined with short sleep (�6hrs/day vs 7-8hrs/day) was associated with the highest number of comorbidities among other sleep combinations. Sleep duration and sleep quality, when adjusted for each other, remained independently associated with both physical and mental disorders. Affective disorders may be more closely related to poor sleep quality compared to abnormal sleep duration. Our findings suggest sleep quality to be a more important indicator for psychological and overall health compared to sleep duration.

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“…On average, more than 30% of human life is spent sleeping [1]. Apart from rejuvenation, sleep is directly associated with the proper function of the central nervous system, blood pressure maintenance, metabolism, catabolism, temperature regulation, memory consolidation and several other essential physiological functions [2]. In recent times, Insomnia or sleeplessness has become a common disorder that is affecting a large global population and impairing the general health and mental wellbeing.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Insomnia and Anxiety: A Double-blind, Randomized, Placebo-controlled Study

Langade

Kanchi

Salve³

et al. 2019

Cureus

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Introduction Insomnia is a prevalent sleep disorder that can profoundly impact a person's physical health and mental wellbeing. Most of the currently available drugs for insomnia exert adverse effects. Hence, alternative herbal therapies could be effective in treating insomnia. Ashwagandha, a proven "Rasayana" from ancient Ayurveda is having the required potential to treat insomnia. Objective To determine the efficacy and safety of Ashwagandha root extract in patients with insomnia and anxiety. Methods This was a randomized, double-blind, placebo-controlled study conducted at Prakruti Hospital, Kalwa, Maharashtra, India. A total of 60 patients were randomly divided into two groups: test (n = 40) and placebo (n = 20) in a randomization ratio of 2:1. Test product was a capsule containing highest concentration full-spectrum Ashwagandha root extract 300 mg, and the placebo was an identical capsule containing starch. Both treatments were given twice daily with milk or water for 10 weeks. Sleep actigraphy (Respironics Philips) was used for assessment of sleep onset latency (SOL), total sleep time (TST), sleep efficiency (SE) and wake after sleep onset (WASO). Other assessments were total time in bed (sleep log), mental alertness on rising, sleep quality, Pittsburgh Sleep Quality Index (PSQI), and Hamilton Anxiety Rating Scale (HAM-A) scales. Results Two patients, one from each group, did not complete study and the per-protocol dataset (n = 58) included 29 and 19 patients from test and placebo, respectively. The baseline parameters were similar in the two groups at baseline. The sleep onset latency was improved in both test and placebo at five and 10 weeks. However, the SOL was significantly shorter (p, 0.019) after 10 weeks with test [29.00 (7.14)] compared to placebo [33.94 (7.65)]. Also, significant improvement in SE scores was observed with Ashwagandha which was 75.63 (2.70) for test at the baseline and increased to 83.48 (2.83) after 10 weeks, whereas for placebo the SE scores changed from 75.14

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Insomnia and mortality: A meta-analysis

Cited by 87 publications

References 57 publications

<p>Association Between Insomnia And Mortality Is Only Evident Among Long Sleepers</p>

<p>Association Between Insomnia And Mortality Is Only Evident Among Long Sleepers</p>

Independent and combined associations of sleep duration and sleep quality with common physical and mental disorders: Results from a multi-ethnic population-based study

Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Insomnia and Anxiety: A Double-blind, Randomized, Placebo-controlled Study

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