Insomnia and heart disease: a review of epidemiologic studies.

Journal Article (Journal Article)

Since the discovery and successful treatment of sleep apnea, researchers seem to believe that the association between sleep disturbance and coronary heart disease (CHD) has been explained. To determine whether subjective nighttime sleep complaints (trouble sleeping, trouble falling asleep, trouble staying asleep), exclusive of apnea, predicted myocardial infarction and other coronary events, a MEDLINE search was conducted for articles published between January 1976 through August 1997. Ten studies with an explicit measure of association between an insomniac complaint and CHD were identified. Reported risk ratios for various sleep complaints and CHD events ranged from 1.0 for waking too early and CHD death in an elderly North Carolina community to 8.0 for the highest versus lowest quintile of a sleep scale in Finnish men. Higher quality studies showed risk ratios of 1.47-3.90 between trouble falling asleep and coronary events after adjusting for age and various coronary risk factors (combined effect=1.7, p<0.0001). While alternative explanations such as medication use still need to be ruled out, we theorize that a subjective insomniac complaint either may be part of a larger syndrome that includes poor health and depression, or it may be related to continual stressors, reduced slow-wave sleep, and autonomic dysfunction, which increase the risk of heart problems.

Full Text

Duke Authors

Cited Authors

  • Schwartz, S; McDowell Anderson, W; Cole, SR; Cornoni-Huntley, J; Hays, JC; Blazer, D

Published Date

  • October 1999

Published In

Volume / Issue

  • 47 / 4

Start / End Page

  • 313 - 333

PubMed ID

  • 10616226

International Standard Serial Number (ISSN)

  • 0022-3999

Digital Object Identifier (DOI)

  • 10.1016/s0022-3999(99)00029-x


  • eng

Conference Location

  • England