Key result
Insomnia alone was not associated with an increased risk of out-of-hospital cardiac arrest (AOR 0.95), but it significantly increased the risk in young patients with comorbid depression (AOR 3.65).
Why the study?
Although insomnia and depression are known risk factors for diseases like coronary heart disease, whether insomnia affects OHCA incidence and if this effect varies with depression remained unestablished.
Does a history of insomnia increase the incidence of out-of-hospital cardiac arrest in adults?
Case-Control (n=2,028)
Yes
Does a history of insomnia increase the incidence of out-of-hospital cardiac arrest in adults?
Odds Ratio: 0.95 (95% CI 0.64–1.4)
While insomnia alone does not increase the risk of out-of-hospital cardiac arrest, the combination of insomnia and depression significantly elevates this risk in younger populations, particularly those not receiving insomnia medication.
BACKGROUND: Insomnia and depression have been known to be risk factors of several diseases, including coronary heart disease. We hypothesized that insomnia affects the out-of-hospital cardiac arrest (OHCA) incidence, and these effects may vary depending on whether it is accompanied by depression. This study aimed to determine the association between insomnia and OHCA incidence and whether the effect of insomnia is influenced by depression. METHODS: This prospective multicenter case-control study was performed using Phase II Cardiac Arrest Pursuit Trial with Unique Registration and Epidemiology Surveillance (CAPTURES-II) project database for OHCA cases and community-based controls in Korea. The main exposure was history of insomnia. We conducted conditional logistic regression analysis to estimate the effect of insomnia on the risk of OHCA incidence and performed interaction analysis between insomnia and depression. Finally, subgroup analysis was conducted in the patients with insomnia. RESULTS: Insomnia was not associated with increased OHCA risk (0.95 [0.64-1.40]). In the interaction analysis, insomnia interacted with depression on OHCA incidence in the young population. Insomnia was associated with significantly higher odds of OHCA incidence (3.65 [1.29-10.33]) in patients with depression than in those without depression (0.84 [0.59-1.17]). In the subgroup analysis, depression increased OHCA incidence only in patients who were not taking insomnia medication (3.66 [1.15-11.66]). CONCLUSION: Insomnia with depression is a risk factor for OHCA in the young population. This trend was maintained only in the population not consuming insomnia medication. Early and active medical intervention for patients with insomnia may contribute to lowering the risk of OHCA.
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Jung et al. (2023) conducted a case-control in Out-of-hospital cardiac arrest (n=2,028). History of insomnia vs. No history of insomnia was evaluated on Incidence of out-of-hospital cardiac arrest (AOR 0.95, 95% CI 0.64-1.40). Insomnia alone was not associated with an increased risk of out-of-hospital cardiac arrest (AOR 0.95), but it significantly increased the risk in young patients with comorbid depression (AOR 3.65).
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