Associations between insomnia and cardiovascular diseases: a meta-review and meta-analysis of observational and Mendelian randomization studies

TY - JOUR

T1 - Associations between insomnia and cardiovascular diseases

T2 - a meta-review and meta-analysis of observational and Mendelian randomization studies

AU - Zhang, Xuejiao

AU - Sun, Yujing

AU - Ye, Shuo

AU - Huang, Qingqing

AU - Zheng, Rui

AU - Li, Zhexi

AU - Yu, Feng

AU - Zhao, Chenhao

AU - Zhang, Min

AU - Zhao, Guoan

AU - Ai, Sizhi

N1 - © 2024 American Academy of Sleep Medicine.

PY - 2024/12/1

Y1 - 2024/12/1

N2 - STUDY OBJECTIVES: Observational studies suggest associations between insomnia and cardiovascular diseases (CVDs), but the causal mechanism remains unclear. We investigated the potential causal associations between insomnia and CVDs by a combined systematic meta-review and meta-analysis of observational and Mendelian randomization studies.METHODS: We searched PubMed, Web of Science, and Embase for English-language articles from inception to July 11, 2023. Two reviewers independently screened the articles to minimize potential bias. We summarized the current evidence on the associations of insomnia with coronary artery disease, atrial fibrillation, heart failure, myocardial infarction, hypertension, and stroke risk by combining meta-analyses of observational and Mendelian randomization studies.RESULTS: Four meta-analyses of observational studies and 9 Mendelian randomization studies were included in the final data analysis. A systematic meta-review of observational studies provided strong evidence that insomnia is an independent risk factor for many CVDs, including atrial fibrillation, myocardial infarction, and hypertension. A meta-analysis of Mendelian randomization studies revealed that insomnia may be potentially causally related to coronary artery disease (odds ratio [OR] = 1.14, 95% confidence interval [CI] = 1.10-1.19, I2 = 97%), atrial fibrillation (OR = 1.02, 95% CI = 1.01-1.04, I2 = 94%), heart failure (OR = 1.04, 95% CI = 1.03-1.06, I2 =97%), hypertension (OR = 1.16, 95% CI = 1.13-1.18, I2 = 28%), large artery stroke (OR = 1.14, 95% CI = 1.05-1.24, I2 = 0%), any ischemic stroke (OR = 1.09, 95% CI = 1.03-1.14, I2 = 60%), and primary intracranial hemorrhage (OR = 1.16, 95% CI = 1.05-1.27, I2 = 0%). No evidence suggested that insomnia is causally associated with cardioembolic or small vessel stroke.CONCLUSIONS: Our results provide strong evidence supporting a possible causal association between insomnia and CVD risk. Strategies to treat insomnia may be promising targets for preventing CVDs.CITATION: Zhang X, Sun Y, Ye S, et al. Associations between insomnia and cardiovascular diseases: a meta-review and meta-analysis of observational and Mendelian randomization studies. J Clin Sleep Med. 2024;20(12):1975-1984.

AB - STUDY OBJECTIVES: Observational studies suggest associations between insomnia and cardiovascular diseases (CVDs), but the causal mechanism remains unclear. We investigated the potential causal associations between insomnia and CVDs by a combined systematic meta-review and meta-analysis of observational and Mendelian randomization studies.METHODS: We searched PubMed, Web of Science, and Embase for English-language articles from inception to July 11, 2023. Two reviewers independently screened the articles to minimize potential bias. We summarized the current evidence on the associations of insomnia with coronary artery disease, atrial fibrillation, heart failure, myocardial infarction, hypertension, and stroke risk by combining meta-analyses of observational and Mendelian randomization studies.RESULTS: Four meta-analyses of observational studies and 9 Mendelian randomization studies were included in the final data analysis. A systematic meta-review of observational studies provided strong evidence that insomnia is an independent risk factor for many CVDs, including atrial fibrillation, myocardial infarction, and hypertension. A meta-analysis of Mendelian randomization studies revealed that insomnia may be potentially causally related to coronary artery disease (odds ratio [OR] = 1.14, 95% confidence interval [CI] = 1.10-1.19, I2 = 97%), atrial fibrillation (OR = 1.02, 95% CI = 1.01-1.04, I2 = 94%), heart failure (OR = 1.04, 95% CI = 1.03-1.06, I2 =97%), hypertension (OR = 1.16, 95% CI = 1.13-1.18, I2 = 28%), large artery stroke (OR = 1.14, 95% CI = 1.05-1.24, I2 = 0%), any ischemic stroke (OR = 1.09, 95% CI = 1.03-1.14, I2 = 60%), and primary intracranial hemorrhage (OR = 1.16, 95% CI = 1.05-1.27, I2 = 0%). No evidence suggested that insomnia is causally associated with cardioembolic or small vessel stroke.CONCLUSIONS: Our results provide strong evidence supporting a possible causal association between insomnia and CVD risk. Strategies to treat insomnia may be promising targets for preventing CVDs.CITATION: Zhang X, Sun Y, Ye S, et al. Associations between insomnia and cardiovascular diseases: a meta-review and meta-analysis of observational and Mendelian randomization studies. J Clin Sleep Med. 2024;20(12):1975-1984.

KW - Humans

KW - Mendelian Randomization Analysis/methods

KW - Sleep Initiation and Maintenance Disorders/complications

KW - Cardiovascular Diseases/epidemiology

KW - Observational Studies as Topic

KW - Risk Factors

U2 - 10.5664/jcsm.11326

DO - 10.5664/jcsm.11326

M3 - Article

C2 - 39167428

SN - 1550-9389

VL - 20

SP - 1975

EP - 1984

JO - Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine

JF - Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine

IS - 12

ER -