Insomnia symptoms and subsequent cardiovascular medication: a register-linked follow-up study among middle-aged employees

Abstract

Introduction Sleep disturbances have been associated with increased risk of cardiovascular disease outcomes. The associations of insomnia with hypertension and dyslipidemia, the main modifiable cardiovascular disease risk factors, are less studied. We aimed to examine associations of insomnia symptoms with subsequent prescribed medication for hypertension and dyslipidemia. Materials and methods Baseline questionnaire surveys among 40–60-year-old employees of the City of Helsinki, Finland, were conducted in 2000–2002 (N = 6,477, response rate 67%, 78% women) and linked to a national register on prescribed reimbursed medication 5–7 years prior to and 5 years after baseline. The associations between the frequency of insomnia symptoms (difficulties in initiating and maintaining sleep, non-restorative sleep) and hypertension and dyslipidemia medication during the follow-up were analysed using logistic regression analysis (odds ratios (OR) with 95% confidence intervals (CI)). Analyses were adjusted for pre-baseline medication, sociodemographic and work-related factors, health, and health behaviours. Results Frequent insomnia symptoms were reported by 20%. During the 5-year follow-up 32% had hypertension medication and 15% dyslipidemia medication. Adjusting for age, gender, and pre-baseline medication, frequent insomnia symptoms were associated with hypertension medication (OR 1.57, 95% CI 1.23–2.00) and dyslipidemia medication (OR 1.59, 95% CI 1.19–2.12). Occasional insomnia symptoms were also associated with cardiovascular medication, though less strongly. Further adjustments had negligible effects. Conclusion Insomnia should be taken into account in the prevention and management of cardiovascular disease and related risk factors. Acknowledgements The authors have no conflicts of interests to report. This study has been funded with grants from Academy of Finland, Finnish Work Environment Fund, Juho Vainio Foundation, Emil Aaltonen Foundation, and Doctoral Programs in Public Health.