scholarly journals 0457 Insomnia and Cause-Specific Mortality in Men and Women

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A175-A175
Author(s):  
F He ◽  
J Fernandez-Mendoza ◽  
A N Vgontzas ◽  
S L Calhoun ◽  
D Liao ◽  
...  
Keyword(s):  
Heart Disease ◽  
Mental Health Problems ◽  
Large Population ◽  
Psychiatric Morbidity ◽  
Population Sample ◽  
Health Problems ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Risk Of Cancer

Abstract Introduction The association of insomnia with an increased risk of mortality has remained inconsistent across studies, which contrasts with accumulating evidence linking this prevalent and chronic sleep disorder with cardiovascular, cerebrovascular, oncologic, and psychiatric morbidity. The higher prevalence of insomnia in women compared to men may be an important contributor to the different survival rates reported in large, population-based studies. Methods The Penn State Adult Cohort is a random, general population sample of 1,741 adults (48.8±13.6y, 52.2% women) who were studied in the sleep laboratory and followed-up for their cause of death up to December 31, 2018. Insomnia was defined as a chronic complaint lasting at least 1 year (n=199). We assessed the risk of all-cause mortality (n=664) and the two most common causes of death: cardiovascular/cerebrovascular (n=275) and cancer (n=161). Cox proportional hazard models adjusted for age, race, sex, education, smoking, alcohol, BMI, AHI, cognitive impairment, mental health problems and physical health problems, including hypertension, diabetes, heart disease, stroke and cancer at baseline. Results The risk of all-cause mortality associated with insomnia was significantly increased in men (HR=1.84, 95%CI=1.18-2.87) but not in women (HR=0.80, 95%CI=0.57-1.13; p for sex-interaction<0.01). Insomnia was significantly associated with an increased risk of cardiovascular/cerebrovascular mortality in men (HR=2.11, 95%CI=1.14-3.99), but not in women (HR=0.98, 95%CI=0.59-1.63; p for sex-interaction=0.06). Insomnia was not significantly associated with an increased risk of cancer mortality either in men (HR=1.41, 95% CI=0.56-3.56) or in women (HR=0.90, 95% CI=0.45-1.80), after adjusting for hypertension, diabetes, heart disease, stroke and cancer at baseline. Conclusion Men with chronic insomnia are at an increased risk of mortality, particularly that of cardiovascular/cerebrovascular origin. There is a need for translational studies focused on sex-differences that can disentangle the biological and behavioral mechanisms underlying women’s resilience. Support American Heart Association (14SDG19830018), National Institutes of Health (R01HL51931, R01HL40916)

Abstract P343: Sex Differences in Cardiovascular/Cerebrovascular Mortality Risk Associated With Chronic Insomnia

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Julio Fernandez-Mendoza ◽  
Fan He ◽  
Alexandros N Vgontzas ◽  
Duanping Liao ◽  
Edward O Bixler
Keyword(s):  
Mental Health Problems ◽  
Cox Regression ◽  
Population Sample ◽  
Health Problems ◽  
Chronic Insomnia ◽  
Poor Sleep ◽  
Sleep Difficulty ◽  
Increased Risk ◽  
Underlying Mechanisms ◽  
Sleep Difficulties

Introduction: It remains unknown whether individuals with chronic insomnia are at increased risk of mortality, particularly cardiovascular or cerebrovascular (CVD/CBV) mortality. Given the higher prevalence of insomnia in women than in men, it is unknown whether its prognosis in terms of mortality is also different across sexes. Hypothesis: The risk of CVD/CBV mortality associated with chronic insomnia is significantly higher than in non-complaining individuals and this risk is modified by sex. Methods: We addressed this question in the Penn State Adult Cohort, a random, general population sample of 1,741 men and women (48.7 ± 13.5 years) who were studied in the sleep laboratory and followed-up for their cause of death up to 15 years. Sleep difficulty was assessed based on three levels of severity: chronic insomnia (i.e., a complaint of chronic sleep difficulties lasting at least 1 year), poor sleep (i.e., moderate-to-severe sleep difficulties at any given time) and none (i.e., absence of either of the two categories). Cox regression models controlled for potential confounders, including age, race, body mass index, years of education, smoking, sleep disordered breathing, alcohol use, mental health problems, hypertension, diabetes, heart disease, stroke and other physical health problems. Results: Poor sleep and chronic insomnia were significantly more prevalent in females (26.7% and 10.7%, respectively) than males (17.6% and 4.1%, respectively). A significant interaction (p = 0.04) showed that the risk of CVD/CBV mortality associated with chronic insomnia was modified by male sex, while poor sleep was not significantly associated with increased risk of CVD/CBV mortality in either males or females. Chronic insomnia was associated with a 2.9-fold (95%CI=1.53-5.61) increased risk of CVD/CBV mortality in males even after adjusting for all confounders, while this risk was not significantly elevated in females (HR=1.13, 95%CI=0.56-2.31). Conclusions: Chronic insomnia is associated with increased risk of CVD/CBV mortality in males, while it has a better prognosis in females despite its higher prevalence. These data suggest potential sex-related vulnerabilities in the underlying mechanisms linking chronic insomnia with CVD/CBV morbidity and mortality.

scholarly journals Increased risk of mortality and readmission associated with lower SF-12 scores in cardiac patients: Results from the national DenHeart study

2019 ◽  
Vol 19 (4) ◽  
pp. 330-338
Author(s):  
Anne Vinggaard Christensen ◽  
Jakob Bue Bjorner ◽  
Ola Ekholm ◽  
Knud Juel ◽  
Lars Thrysoee ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Mental Component Summary ◽  
Mental Component Summary Score ◽  
Summary Score ◽  
Cardiac Patients ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Increase In Risk

Background: The SF-12v2 health survey (SF-12) is widely used as a generic measure of health-related quality of life. However, interpretation of score differences can be difficult. Aim: To estimate benchmarks for interpretation of score differences on the SF-12 for readmission and all-cause mortality in cardiac patients. Methods: Data from the DenHeart study, a national cross-sectional survey including one year follow-up register data, were used. Patients with ischaemic heart disease, arrhythmia, heart failure and heart valve disease answered the survey at hospital discharge. Cox proportional hazards models were used to regress readmission and all-cause mortality. Results: A total of 10,813 cardiac patients completed the SF-12. For patients with ischaemic heart disease and arrhythmia, a one point lower physical component summary score was associated with a 2% increase in risk in readmission (hazard ratio (HR) 1.022 (95% confidence interval 1.017;1.027) and HR 1.024 (1.018; 1.029), respectively) and a 3% increase in risk for patients with heart failure (HR 1.027 (1.015; 1.038)). A one point lower mental component summary score was associated with a 2% increase in the risk of readmission (HR 1.017 (1.013; 1.022)) across diagnoses. For both the physical and mental component summary score, a one point lower score meant a 5% increase in the risk of all-cause mortality (HR 1.046 (1.031; 1.060) and HR 1.046 (1.029; 1.065), respectively) across diagnoses. Conclusion: In a large group of cardiac patients, a one point lower physical or mental component summary score was associated with an up to 3% increased risk of readmission and a 5% increased risk of mortality in the first year after discharge.

scholarly journals Association between changes in lifestyle and all-cause mortality: the Health and Lifestyle Survey

2018 ◽  
Vol 72 (8) ◽  
pp. 711-714 ◽  
Author(s):  
James White ◽  
Giles Greene ◽  
Mika Kivimaki ◽  
G David Batty
Keyword(s):  
Physical Activity ◽  
Fruits And Vegetables ◽  
Population Sample ◽  
Health Behaviours ◽  
Unhealthy Lifestyle ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Modal Change ◽  
The Uk

BackgroundTo examine the combined influence of changes in physical activity, diet, smoking and alcohol consumption on all-cause mortality.MethodsHealth behaviours were assessed in 1984/1985 and 1991/1992 in 8123 adults from the UK (4666 women, median age 41.0 years). An unhealthy lifestyle score was calculated, allocating one point for smoking, fruits and vegetables <3 times a day, physical activity <2 hours a week and >14 units (women) or >21 units of alcohol (men) per week.ResultsThere were 2003 deaths over a median follow-up of 6.6 years (IQR 5.9–7.2) following the resurvey. The modal change in the unhealthy lifestyle score was zero, 41.8% had the same score, 35.5% decreased and 22.7% increased score between surveys. A one unit decrease in the unhealthy lifestyle score was not associated with a beneficial effect on mortality (HR 0.93; 95% CI 0.83 to 1.04). A one unit increase in the unhealthy lifestyle score increased the risk of mortality (adjusted HR 1.09; 95% CI 1.01 to 1.18).ConclusionsIn this general population sample, the adoption of an unhealthy lifestyle was associated with an increased risk of mortality.

Abstract MP23: Interplay of Cognitive Impairment and Short Sleep Duration on Cardiovascular and Cerebrovascular Mortality

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Julio Fernandez-Mendoza ◽  
Fan He ◽  
Susan L Calhoun ◽  
Duanping Liao ◽  
Alexandros N Vgontzas ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Sleep Duration ◽  
Mental Health Problems ◽  
Middle Age ◽  
Experimental Studies ◽  
Health Problems ◽  
Short Sleep Duration ◽  
Short Sleep ◽  
Increased Risk ◽  
All Cause Mortality

Introduction: Epidemiological and experimental studies have shown that short sleep duration is associated with cognitive impairment as well as cardiovascular (CVD) and cerebrovascular (CBV) diseases. However, its role in predicting CVD/CBV mortality is still not well-established, particularly using objective sleep measures. Hypothesis: Polysomnography (PSG)-measured short sleep duration modifies the increased risk of CVD/CBV mortality associated with cognitive impairment in middle-age. Methods: We addressed this hypothesis in the Penn State Adult Cohort, a random, population-based sample studied in the sleep laboratory (N=1,524, 48.9±13.4y, 54% women) and followed-up after 20.5 ± 5.7 years to ascertain their cause of death. Cognitive impairment (n=155) was ascertained using a comprehensive neuropsychological battery including Mini-Mental State Examination, Symbol Digit Modalities Test, Trail Making Test parts A and B, Benton Visual Retention Test and Thurstone Word Fluency Test. PSG total sleep time classified subjects as normal (≥6 h) and short (<6 h) sleepers. Out of the 563 subjects who were deceased as of December 31, 2018, 244 died of CVD/CBV. Cox proportional hazards regression controlling for age, sex, race, education, obesity, sleep apnea, mental health problems and physical health problems, including hypertension, diabetes, heart disease and stroke at baseline, was used to assess the association between cognitive impairment and mortality. Results: Cognitive impairment was associated with an increased risk of all-cause mortality [(HR: 1.72 (1.35-2.06)], which was significantly modified by objective sleep duration (p-interaction=0.01). The association between cognitive impairment and all-cause mortality was significantly stronger among subjects who slept < 6 hours [HR: 2.00 (1.54-2.59)] than among those who slept ≥ 6 hours [HR: 1.00 (0.59-1.67)]. Despite the smaller sample size, we observed a similar pattern (p-interaction=0.18) that the association between cognitive impairment and CVD/CBV mortality was stronger among subjects who slept < 6 hours [HR: 2.09 (1.43-3.05)] than among those who slept ≥ 6 hours [HR: 1.24 (0.60-2.57)]. Conclusions: The risk of mortality associated with cognitive impairment in middle-age is significantly increased in adults with objective short sleep duration. Middle-aged adults who sleep objectively short may be more vulnerable to the effect of clinical and subclinical cerebrovascular morbidity on cognitive impairment and, thus, early death from CVD/CBV.

Psychosocial work stressors and risk of mortality in Australia: analysis of data from the Household, Income and Labour Dynamics in Australia survey

2020 ◽  
Vol 77 (4) ◽  
pp. 256-264
Author(s):  
Yamna Taouk ◽  
Anthony D LaMontagne ◽  
Matthew J Spittal ◽  
Allison Milner
Keyword(s):  
Household Income ◽  
Population Sample ◽  
Job Demands ◽  
Cox Proportional Hazards ◽  
Job Control ◽  
Psychosocial Work ◽  
Work Stressors ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
All Cause Mortality

ObjectiveTo examine the association between exposures to psychosocial work stressors and mortality in a nationally representative Australian working population sample.Methods18 000 participants from the Household, Income and Labour Dynamics in Australia survey with self-reported job demands, job control, job security and fair pay psychosocial work stressors exposures at baseline were followed for up to 15 waves. Cox proportional hazards regression models were used to examine the association between psychosocial work stressors and mortality. Models were serially adjusted for each subgroup of demographic, socioeconomic, health and behavioural risk factors.ResultsLow job control was associated with a 39% increase in the risk of all-cause mortality (HR 1.39; 95% CI 1.04 to 1.85), controlling for demographic, socioeconomic, health and behavioural factors. A decreased risk of mortality was observed for workers with exposure to high job demands (HR 0.76; 95% CI 0.60 to 0.96, adjusted for gender and calendar), but the risk was attenuated after serially adjusting for socioeconomic status, health (HR=0.84; 95% CI 0.65 to 1.08) and behavioural (HR=0.79; 95% CI 0.60 to 1.04) factors. There did not appear to be an association between exposure to job insecurity (HR 1.03; 95% CI 0.79 to 1.33) and mortality, or unfair pay and mortality (HR 1.04; 95% CI 0.80 to 1.34).ConclusionsLow job control may be associated with an increased risk of all-cause mortality. Policy and practice interventions that reduce the adverse impact of low job control in stressful work environments could be considered to improve health and decrease risk of mortality.

The Widowhood Effect–mortality and Adverse Health Effects When Losing a Spouse in Old Age

2017 ◽  
Vol 41 (S1) ◽  
pp. S656-S656
Author(s):  
C.B. Kristiansen ◽  
A.B. Bojesen ◽  
P. Munk-Jørgensen ◽  
K. Andersen
Keyword(s):  
Mental Health ◽  
Health Effects ◽  
Old Age ◽  
Service Use ◽  
Mental Health Problems ◽  
Population Sample ◽  
Adverse Health Effects ◽  
Adverse Health ◽  
Risk Of Mortality ◽  
Increased Risk

IntroductionLosing one's spouse is a major life event which is associated to an increased risk of mental health problems as depression and sleep-disorders. There is also an increased risk of adverse effects on physical health, and even an increased risk of mortality. A phenomena called “the widowhood effect” Though this is well-known clinically, few studies have established the extent of the problem in old age.ObjectivesThis study aims to examine the risk of mortality associated to widowhood in old age, and adverse health effects both regarding physical and mental health.MethodsA nationwide register-based case control study. All Danish people aged 65 years and above who became widowed in the period of 2000–2010 are included. A background population sample of 4:1 is matched on age and gender. By using the personal identification number a linkage between registers containing information regarding health service use, pharmacologic use and demographic information is made. Mortality is analysed using Kaplan-Meier estimate and the statistical comparison between the groups is done by Cox-regression. Adverse health effects are assessed by the health care use and pharmacological use, and are compared between the two groups by t-test, linear and logistic regression depending on the variables.ResultsThe study is under conduction, results will be presented.ConclusionsWidowhood in old age has been associated to an increased risk of mortality and adverse health effects. This study assesses the outcome of this in a nationwide register-based sample.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Low Physical Activity in Adolescence is Associated with Increased Risk for Mental Health Problems

2009 ◽  
Vol 13 (2) ◽  
pp. 74-81 ◽  
Author(s):  
Karin Monshouwer ◽  
Margreet ten Have ◽  
Mireille Van Poppel ◽  
Han Kemper ◽  
Wilma Vollebergh
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Mental Health Problems ◽  
Health Problems ◽  
Increased Risk

Family Type Predicts Mental Health Problems in Young Adults: A Survey of Students at a University in Botswana

2020 ◽  
Vol 32 (2) ◽  
Author(s):  
Kennedy Amone-P'Olak ◽  
Boniface Kealeboga Ramotuana
Keyword(s):  
Mental Health ◽  
Young Adults ◽  
Mental Health Problems ◽  
Single Mother ◽  
Health Problems ◽  
Family Type ◽  
Cross Sectional ◽  
Intact Family ◽  
Increased Risk ◽  
Family Types

In Africa, the structure of the family is changing rapidly. The effects of this change on mental health remain unknown. This study investigated the extent to which different family types (intact, single-mother, and multiple) predict mental health problems in young adults in Botswana (N = 264, mean age = 21.31, SD = 2.40). In a cross-sectional design, the study sampled students registered at various faculties at the University of Botswana. The revised symptoms checklist (SCL-90-R) was used to assess symptoms of mental health problems (depression, anxiety and hostility). Binary logistic regression analyses were performed to obtain odds ratios (ORs) and 95 per cent confidence intervals (CIs) of mental health problems for mother-only and multiple family types relative to the intact family type. Compared to the intact family type, single-mother (OR = 2.34; 95% CI: 1.21, 4.51) and multiple family types (OR = 1.56; CI: 0.88, 2.78) were associated with an increased risk of depression. For anxiety, the ORs were 2.27 (CI: 1.18, 4.38) and 1.10 (CI: 0.56, 1.82) for single-mother and multiple family types respectively. For hostility, the ORs were 2.60 (CI: 1.34, 5.04), and 0.79 (CI: 0.44, 1.42) for single-mother and multiple family types, respectively. Family types predict mental health problems in young adults and therefore the interventions to mitigate the effects should consider family backgrounds and the ramifications of family types for treatment and care.

scholarly journals Factors Associated with Mental Health Problems among Malaysian Children: A Large Population-Based Study

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 119
Author(s):  
Norhafizah Sahril ◽  
Noor Ani Ahmad ◽  
Idayu Badilla Idris ◽  
Rajini Sooryanarayana ◽  
Mohamad Aznuddin Abd Razak
Keyword(s):  
Mental Health ◽  
Formal Education ◽  
Mental Health Problems ◽  
Large Population ◽  
Multiple Logistic Regression Analysis ◽  
Population Based ◽  
Health Problems ◽  
Public Health Issue ◽  
Factors Associated ◽  
Lower Socioeconomic

Mental health problems are a major public health issue, particularly among children. They impair children’s development, academic achievement, and ability to live a productive life. The present study aimed to determine the prevalence and factors associated with mental health problems among children aged 5 to 15 years old in Malaysia. Data from the National Health and Morbidity Survey (NHMS) 2015 were analyzed. A validated Strengths and Difficulties Questionnaire (SDQ) was used. The overall prevalence of mental health problems among children in Malaysia was 11.1%. Multiple logistic regression analysis revealed that for every year increment in age, mental health problems decreased by 5%. Further analysis found that children who had fathers with a non-formal education and worked in the private sector, had parents who were widowed or divorced, and had either parent with mental health problems were more likely to have mental health problems themselves. Children from the lower socioeconomic group and who had either parent with mental health problems had higher odds of having mental health problems in Malaysia.

scholarly journals Role of depressive symptoms in cardiometabolic diseases and subsequent transitions to all-cause mortality: an application of multistate models in a prospective cohort study

2021 ◽  
pp. svn-2020-000693
Author(s):  
Yanan Qiao ◽  
Siyuan Liu ◽  
Guochen Li ◽  
Yanqiang Lu ◽  
Ying Wu ◽  
...  
Keyword(s):  
Heart Disease ◽  
Depressive Symptoms ◽  
Depression Scale ◽  
European Population ◽  
Multistate Models ◽  
Cardiometabolic Diseases ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Patients With Diabetes

Background and purposeThe role of depression in the development and outcome of cardiometabolic diseases remains to be clarified. We aimed to examine the extent to which depressive symptoms affect the transitions from healthy to diabetes, stroke, heart disease and subsequent all-cause mortality in a middle-aged and elderly European population.MethodsA total of 78 212 individuals aged ≥50 years from the Survey of Health Ageing and Retirement in Europe were included. Participants with any baseline cardiometabolic diseases including diabetes, stroke and heart disease were excluded. Depressive symptoms were measured by the Euro-Depression scale at baseline. Participants were followed up to determine the occurrence of cardiometabolic diseases and all-cause mortality. We used multistate models to estimate the transition-specific HRs and 95% CIs after adjustment of confounders.ResultsDuring 500 711 person-years of follow-up, 4742 participants developed diabetes, 2173 had stroke, 5487 developed heart disease and 7182 died. Depressive symptoms were significantly associated with transitions from healthy to diabetes (HR: 1.12, 95% CI: 1.05 to 1.20), stroke (HR: 1.31, 95% CI: 1.18 to 1.44), heart disease (HR: 1.26, 95% CI: 1.18 to 1.34) and all-cause mortality (HR: 1.41, 95% CI: 1.34 to 1.49). After cardiometabolic diseases, depressive symptoms were associated with the increased risk of all-cause mortality in patients with diabetes (HR: 1.54, 95% CI: 1.25 to 1.89), patients who had stroke (HR: 1.29, 95% CI: 1.03 to 1.61) and patients with heart disease (HR: 1.21, 95% CI: 1.02 to 1.44).ConclusionsDepressive symptoms increase the risk of diabetes, stroke and heart disease, and affect the risk of mortality after the onset of these cardiometabolic conditions. Screening and treatment of depressive symptoms may have profound implications for the prevention and prognosis of cardiometabolic diseases.

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