Relapse insomnia increases greater risk of anxiety and depression: evidence from a population-based 4-year cohort study

doi:10.1016/j.sleep.2017.07.016

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Title:	Relapse insomnia increases greater risk of anxiety and depression: evidence from a population-based 4-year cohort study
Authors:	Chen, Ping-Jen Huang, Charles Lung-Cheng Weng, Shih-Feng Wu, Ming-Ping Ho, Chung-Han Wang, Jhi-Joung Tsai, Wan-Chi Hsu, Ya-Wen
Contributors:	Chi Mei Med Ctr, Dept Geriatr & Gerontol Kaohsiung Med Univ,Kaohsiung Med Univ Hosp, Dept Family Med Chi Mei Med Ctr, Dept Psychiat Chia Nan Univ Pharm & Sci, Dept Social Work Kaohsiung Med Univ, Dept Healthcare Adm & Med Informat Chi Mei Med Ctr, Dept Obstet & Gynecol Chi Mei Med Ctr, Dept Med Res Chia Nan Univ Pharm & Sci, Ctr Gen Educ Chia Nan Univ Pharm & Sci, Dept Hosp & Hlth Care Adm Kaohsiung Med Univ, Dept Med Lab Sci & Biotechnol
Keywords:	Insomnia Anxiety Depression Subtype Longitudinal
Date:	2017-10
Issue Date:	2018-11-30 15:56:58 (UTC+8)
Publisher:	Elsevier Science Bv
Abstract:	Objective: We investigated the longitudinal impacts of insomnia on the subsequent developments of anxiety and depression during a four-year follow-up. We further categorized individuals with insomnia into different insomnia subgroups to examine whether the risk of anxiety and depression varies by subtype. Methods: Participants were identified from National Health Insurance enrollees in Taiwan during 2002 -2009. The study included 19,273 subjects with insomnia and 38,546 matched subjects without insomnia. All subjects did not have previous diagnosis of insomnia, sleep apnea, anxiety, or depression. Results: Compared with non-insomniacs, insomniacs had a higher risk of developing anxiety only [adjusted hazard ratio (HR) = 8.83, 95% CI = 7.59-10.27], depression only (adjusted HR = 8.48, 95% CI = 6.92-10.39), and both anxiety and depression (adjusted HR = 17.98, 95% CI = 12.65-25.56). When breaking down the insomnia subgroups, individuals with a relapse of insomnia (adjusted HR = 10.42 -26.80) had the highest risk of anxiety only, depression only, and both anxiety and depression, followed by persistent insomnia (adjusted HR = 9.82-18.98), then remitted insomnia (adjusted HR = 4.50-8.27). All three insomnia subgroups had a greater four-year cumulative incidence rate than the non-insomnia group for anxiety only, depression only, and both anxiety and depression (p < 0.0001). Conclusion: Our findings reinforce the clinical predictor role of insomnia in the future onset of anxiety or/and depression. Awareness of insomnia and treatment of insomnia should be recommended at clinics, and patterns of insomnia should be monitored to help treatment and control of subsequent psychiatric disorders. Future research with comprehensive data collection is needed to identify factors that contribute to different insomnia subtypes. (C) 2017 Elsevier B.V. All rights reserved.
Relation:	Sleep Medicine, v.38, pp.122-129
Appears in Collections:	[The Center For General Education] Periodical Articles

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