Assosiasjon mellom ulike typer insomni og subklinisk myokardskade.
Forskere fra Akershus Universitetssykehus, Universitetet i Oslo, Brigham and Women's Hospital-Boston, Harvard Medical School-Boston, Inova Fairfax Medical Campus-Falls Church og Johns Hopkins Hospital and School of Medicine-Baltimore har i denne studien undersøkt sammenheng mellom ulike typer av insomni og subklinisk myokardskade, målt ved hjertetroponin T i blodet (cTnT), hos 2188 deltagere i MESA-studien. Forskerne konkluderte med at søvnapné med komorbid insomni (COMISA) og insomni med kort søvnlengde, var assosiert med økt sirkulerende cTnT, noe som er en markør for myokardskade. Det ble ikke gjort lignende funn hos pasienter med kun insomnisymptomer.
Methods: We measured cTnT in 2188 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) study who had completed sleep questionnaires and undergone unattended polysomnography (PSG) and 7-day actigraphy. Insomnia symptoms were defined as reporting at least one of the following ≥5 nights/week over the past four weeks: trouble falling asleep, waking up several times a night, having trouble getting back to sleep after you woke up too early or taking sleeping pills to help them sleep. OSA was defined as an apnea hypopneas index (AHI) >15. Participants were classified into insomnia phenotypes, including comorbid insomnia and OSA (COMISA) and insomnia associated with actigraphy estimated short sleep (<6hrs) or sleep fragmentation.
Results: The mean age was 68.6 years (SD 9.2), 53.6% were male. 47.8% met threshold levels for insomnia symptoms, and 43.1% had an AHI >15. In adjusted linear regression models COMISA (ß 0.08 (SE 0.03), p<0.01) or insomnia with short sleep duration (ß 0.07 (SE 0.03), p<0.05) were each associated with higher cTnT compared to a reference group with no insomnia. Insomnia with fragmented sleep (ß 0.03 (SE 0.02)) was not associated with higher cTnT (p>0.05) in adjusted analyses. OSA was associated with higher cTnT (ß 0.09 (SE 0.03), p<0.01) in adjusted models.
Conclusions: COMISA and insomnia with short sleep duration, but not insomnia symptoms alone or fragmented sleep, were associated with increased circulating cTnT in older adults.