Relapse insomnia increases greater risk of anxiety and depression: evidence from a population-based 4-year cohort study |
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| Affiliation: | 1. Department of Geriatrics and Gerontology, Chi-Mei Medical Center, Tainan, Taiwan;2. Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;3. Department of Psychiatry, Chi-Mei Medical Center, Tainan, Taiwan;4. Department of Social Work, Chia Nan University of Pharmacy and Science, Tainan, Taiwan;5. Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan;6. Department of Obstetrics and Gynecology, Chi-Mei Medical Center, Tainan, Taiwan;7. Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan;8. Center of General Education, Chia Nan University of Pharmacy and Science, Tainan, Taiwan;9. Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan;10. Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan;1. Korea University Ansan Hospital, Institute of Human Genomic Study, Ansan, Republic of Korea;2. Stanford University, Department of Psychiatry, Palo Alto, CA, United States;3. Yongmoon Graduate School of Counseling Psychology, Seoul, Republic of Korea;4. Department of Psychology, Boston University, Boston, MA, United States;5. Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea;1. Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China;2. Shanghai Key Laboratory of Psychotic Disorders, Shanghai 201108, China;3. CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai 200031, China;4. Huangpu District Mental Health Center, Shanghai 200001, China;5. Department of Psychiatry and Neuropsychology, Shanghai Deji Hospital, Qingdao University, Shanghai 200331, China;6. Shenzhen Mental Health Center, Shenzhen 518020, China;7. Hangzhou Seventh People''s Hospital, Mental Health Center Zhejiang University School of Medicine, Hangzhou 310013, China;1. Department of Psychology, University of California, Berkeley, USA;2. Department of Psychiatry, University of Pittsburgh Medical Center, USA;3. Department of Psychiatry & Behavioral Science, Stanford University Medical Center, USA;1. National Institute on Drug Dependence and Beijing Key laboratory of Drug Dependence, Peking University, Beijing 100191, China;2. Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China;3. School of Public Health, Peking University, Beijing 100191, China;4. Sleep Medicine Center, West China Hospital, Sichuan University, Sichuan 610041, China;5. Peking-Tsinghua Center for Life Sciences, PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100191, China |
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| Abstract: | ObjectiveWe 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.MethodsParticipants 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.ResultsCompared 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).ConclusionOur 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. |
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| Keywords: | Insomnia Anxiety Depression Subtype Longitudinal |
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