{"title":"Insomnia symptom trajectories and incident cardiovascular disease in older adults: a longitudinal cohort study.","authors":"Qing-Mei Huang, Hao-Yu Yan, Huan Chen, Jia-Hao Xie, Jian Gao, Zhi-Hao Li, Chen Mao","doi":"10.1136/heartjnl-2024-325362","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Insomnia symptoms are prevalent in older adults and linked to cardiovascular disease (CVD), but the role of long-term symptom trajectories remains unclear. We investigated associations between insomnia symptoms, their trajectories over time and incident CVD in a population-based cohort.</p><p><strong>Methods: </strong>This longitudinal study included 12 102 participants aged ≥50 years without baseline CVD from the US Health and Retirement Study (2002-2018). Insomnia symptoms (non-restorative sleep, difficulty initiating/maintaining sleep, early awakening) were assessed at baseline; trajectories were modelled over 4 years (2002-2006) using latent class analysis. Cox models estimated HRs for incident CVD (heart disease or stroke), adjusted for sociodemographics, lifestyle and comorbidities.</p><p><strong>Results: </strong>During a median of 10.2-year follow-up, 3962 incident CVD events occurred. Compared with no symptoms, participants with one, two, or three to four symptoms had higher CVD risk (HR 1.16, 95% CI 1.05 to 1.27; HR 1.16, 95% CI 1.05 to 1.28; HR 1.26, 95% CI 1.15 to 1.38, respectively). Four trajectories were identified: persistent low (56.3%), decreasing (27.1%), increasing (7.2%) and persistent high (9.5%). Compared with persistent low, increasing (HR 1.28, 95% CI 1.10 to 1.50) and persistent high (HR 1.32, 95% CI 1.15 to 1.50) trajectories were associated with elevated CVD risk.</p><p><strong>Conclusions: </strong>Greater burden of insomnia symptoms at baseline and trajectories over time were associated with higher CVD incidence in older adults.</p>","PeriodicalId":12835,"journal":{"name":"Heart","volume":" ","pages":""},"PeriodicalIF":5.1000,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/heartjnl-2024-325362","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Insomnia symptoms are prevalent in older adults and linked to cardiovascular disease (CVD), but the role of long-term symptom trajectories remains unclear. We investigated associations between insomnia symptoms, their trajectories over time and incident CVD in a population-based cohort.
Methods: This longitudinal study included 12 102 participants aged ≥50 years without baseline CVD from the US Health and Retirement Study (2002-2018). Insomnia symptoms (non-restorative sleep, difficulty initiating/maintaining sleep, early awakening) were assessed at baseline; trajectories were modelled over 4 years (2002-2006) using latent class analysis. Cox models estimated HRs for incident CVD (heart disease or stroke), adjusted for sociodemographics, lifestyle and comorbidities.
Results: During a median of 10.2-year follow-up, 3962 incident CVD events occurred. Compared with no symptoms, participants with one, two, or three to four symptoms had higher CVD risk (HR 1.16, 95% CI 1.05 to 1.27; HR 1.16, 95% CI 1.05 to 1.28; HR 1.26, 95% CI 1.15 to 1.38, respectively). Four trajectories were identified: persistent low (56.3%), decreasing (27.1%), increasing (7.2%) and persistent high (9.5%). Compared with persistent low, increasing (HR 1.28, 95% CI 1.10 to 1.50) and persistent high (HR 1.32, 95% CI 1.15 to 1.50) trajectories were associated with elevated CVD risk.
Conclusions: Greater burden of insomnia symptoms at baseline and trajectories over time were associated with higher CVD incidence in older adults.
期刊介绍:
Heart is an international peer reviewed journal that keeps cardiologists up to date with important research advances in cardiovascular disease. New scientific developments are highlighted in editorials and put in context with concise review articles. There is one free Editor’s Choice article in each issue, with open access options available to authors for all articles. Education in Heart articles provide a comprehensive, continuously updated, cardiology curriculum.