Insomnia and the Risk of Acute Myocardial Infarction: A Population Study
Abstract
Background—: Few prospective studies have investigated insomnia in relation to risk for coronary heart disease. We assessed insomnia symptoms and risk of acute myocardial infarction (AMI) in a large, population-based study. Methods and Results—: A total of 52 610 men and women were followed up for a first AMI, and 2368 incident AMIs occurred during 11.4 years of follow-up, either identified at hospitals or by the National Cause of Death Registry. In our analyses, we adjusted for age, sex, marital status, education, shift work, blood pressure, lipids, diabetes mellitus, body mass index, physical activity, smoking, and alcohol consumption. Difficulties initiating and maintaining sleep and having a feeling of nonrestorative sleep were associated with a moderate increase in AMI risk. The multiadjusted hazard ratios for AMI were 1.45 (95% confidence interval 1.18–1.80) for people with difficulties initiating sleep almost every night, 1.30 (1.01–1.68) for those with difficulties maintaining sleep almost every night, and 1.27 (1.03–1.57) for those with a feeling of nonrestorative sleep more than once a week compared with people who never experienced these sleep difficulties. When we combined the symptoms, a dose-dependent association was seen between the number of insomnia symptoms and AMI risk ( P for trend 0.003). Alternative multivariable models and different sensitivity analyses suggest that the results were robust, especially concerning difficulties initiating sleep. Conclusions—: Insomnia is associated with a moderately increased risk for AMI.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Insomnia symptoms are generally associated with coronary heart disease, with some evidence that the association is stronger in women.
“Studies that have investigated the association between insomnia symptoms and CHD have generally found an association, although sex differences may exist.”
From Sleep Duration and Quality: Impact on Lifestyle Behaviors and Cardiometabolic Health: A Scientific Statement From the American Heart Association (2016) · cites this paper as [118]
Cites
The validity of the Hospital Anxiety and Depression Scale
Bjelland, I., Dahl, A. A., Haug, T. T., & Neckelmann, D. (2002) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(01)00296-3 · Cited by 9,779 · see citing works
Antman, E. M., Bassand, J., Klein, W. W., Ohman, M. E., Sendón, J. L. L., Rydén, L., Simoons, M. L., & Tendera, M. (2000) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(00)00804-4 · Cited by 4,824 · see citing works
Epidemiology of insomnia: what we know and what we still need to learn
Ohayon, M. M. (2002) · Sleep Medicine Reviews · doi:10.1053/smrv.2002.0186 · Cited by 3,743 · cited 2× · see citing works
“The participants were classified as (1) inactive if they reported less than 1 hour of hard and less than 3 hours of light physical activity per week, (2) moderately active if they reported 1 to 3 hours of hard or 3 hours of light activity per week, and (3) physically active if they reported 3 hours of hard physical ac…”
BackgroundMethodImpact of sleep debt on metabolic and endocrine function
Spiegel, K., Leproult, R., & Van Cauter, E. (1999) · The Lancet · doi:10.1016/s0140-6736(99)01376-8 · Cited by 3,672 · see citing works
Mortality Associated With Sleep Duration and Insomnia
Kripke, D. F., Garfinkel, L., Wingard, D. L., Klauber, M. R., & Marler, M. R. (2002) · Archives of General Psychiatry · doi:10.1001/archpsyc.59.2.131 · Cited by 1,614 · see citing works
Mykletun, A., Stordal, E., & Dahl, A. A. (2001) · British Journal of Psychiatry · doi:10.1192/bjp.179.6.540 · Cited by 908 · see citing works
Association of sleep apnoea with myocardial infarction in men
Hung, J., Whitford, E. G., Hillman, D. R., & Parsons, R. W. (1990) · The Lancet · doi:10.1016/0140-6736(90)91799-g · Cited by 905 · see citing works
Nonpharmacologic Treatment of Chronic Insomnia
Morin, C. M., Hauri, P. J., Espie, C. A., Spielman, A. J., Buysse, D. J., & Bootzin, R. R. (1999) · Sleep · doi:10.1093/sleep/22.8.1134 · Cited by 888 · see citing works
Comorbidity of Chronic Insomnia With Medical Problems
Taylor, D. J., Mallory, L. J., Lichstein, K. L., Durrence, H. H., Riedel, B. W., & Bush, A. J. (2007) · Sleep · doi:10.1093/sleep/30.2.213 · Cited by 875 · see citing works
Prevalence, course, and comorbidity of insomnia and depression in young adults.
Buysse, D. J., Angst, J., Gamma, A., Ajdacic, V., Eich, D., & Rössler, W. (2008) · Sleep · doi:10.1093/sleep/31.4.473 · Cited by 858 · see citing works
Use of sleep hygiene in the treatment of insomnia
Stepanski, E. J., & Wyatt, J. K. (2003) · Sleep Medicine Reviews · doi:10.1053/smrv.2001.0246 · Cited by 733 · see citing works
Multiplicative Models and Cohort Analysis
Breslow, N. E., Lubin, J. H., Marek, P. M., & Langholz, B. M. (1983) · Journal of the American Statistical Association · doi:10.1080/01621459.1983.10477915 · Cited by 566 · see citing works
The Nord-Trøndelag Health Study 1995-97 (HUNT 2): Objectives, contents, methods and participation
Holmen, J., Midthjell, K., Krüger, Ø., Langhammer, A., Holmen, T. L., Bratberg, G. H., Vatten, L., & Lund‐Larsen, P. G. (2003) · Cited by 526 · see citing works
Self-citationCappuccio, F. P., Stranges, S., Kandala, N.-B., Miller, M. A., Taggart, F. M., Kumari, M., Ferrie, J. E., Shipley, M. J., Brunner, E. J., & Marmot, M. G. (2007) · Hypertension · doi:10.1161/hypertensionaha.107.095471 · Cited by 512 · see citing works
Mallon, L., Broman, J. ‐., & Hetta, J. (2002) · Journal of Internal Medicine · doi:10.1046/j.1365-2796.2002.00941.x · Cited by 495 · see citing works
Riemann, D., & Perlis, M. L. (2009) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2008.06.001 · Cited by 477 · see citing works
Eaker, E. D., Pinsky, J. L., & Castelli, W. P. (1992) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a116381 · Cited by 383 · see citing works
Chien, K.-L., Chen, P.-C., Hsu, H.-C., Su, T.-C., Sung, F.-C., Chen, M.-F., & Lee, Y.-T. (2010) · SLEEP · doi:10.1093/sleep/33.2.177 · Cited by 350 · see citing works
Sleep-wake disorders based on a polysomnographic diagnosis. A national cooperative study
Coleman, R. M. (1982) · JAMA · doi:10.1001/jama.247.7.997 · Cited by 342 · see citing works
Practice Parameters for Using Polysomnography to Evaluate Insomnia: An Update
Littner, M., Hirshkowitz, M., Kramer, M., Kapen, S., Anderson, W. M., Bailey, D., Berry, R. B., Davila, D., Johnson, S., Kushida, C., et al. (2003) · Sleep · doi:10.1093/sleep/26.6.754 · Cited by 306 · see citing works
Meisinger, C., Heier, M., Löwel, H., Schneider, A., & Döring, A. (2007) · Sleep · doi:10.1093/sleep/30.9.1121 · Cited by 305 · see citing works
Chandola, T., Ferrie, J. E., Perski, A., Akbaraly, T., & Marmot, M. G. (2010) · Sleep · doi:10.1093/sleep/33.6.739 · Cited by 284 · see citing works
Early-Onset Depression, Anxiety, and Risk of Subsequent Coronary Heart Disease
Janszky, I., Ahnve, S., Lundberg, I., & Hemmingsson, T. (2010) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.03.033 · Cited by 260 · see citing works
Self-citationSleep-Wake Disorders Based on a Polysomnographic Diagnosis
Coleman, R. M. (1982) · JAMA · doi:10.1001/jama.1982.03320320033026 · Cited by 250 · see citing works
Suarez, E. C. (2008) · Brain, Behavior, and Immunity · doi:10.1016/j.bbi.2008.01.011 · Cited by 248 · see citing works
Sleep disturbance, stroke, and heart disease events: evidence from the Caerphilly cohort
Elwood, P. C., Hack, M., Pickering, J., Hughes, J., & Gallacher, J. (2005) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2005.039057 · Cited by 236 · see citing works
Do Insomnia Complaints Cause Hypertension or Cardiovascular Disease?
Phillips, B. A., & Mannino, D. M. (2007) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.26913 · Cited by 227 · see citing works
Comorbidity between sleep apnea and insomnia
Benetó, A., Gomez-Siurana, E., & Rubio-Sanchez, P. (2009) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2008.09.006 · Cited by 171 · see citing works
Insomnia complaints in patients evaluated for obstructive sleep apnea
Krell, S. B., & Kapur, V. K. (2005) · Sleep And Breathing · doi:10.1007/s11325-005-0026-x · Cited by 163 · see citing works
Ursin, R., Bjorvatn, B., & Holsten, F. (2005) · SLEEP · doi:10.1093/sleep/28.10.1260 · Cited by 145 · see citing works
Are Sleep Complaints an Independent Risk Factor for Myocardial Infarction?
Schwartz, S. W., Cornoni‐Huntley, J. C., Cole, S. R., Hays, J. C., Blazer, D. G., & Schocken, D. D. (1998) · Annals of Epidemiology · doi:10.1016/s1047-2797(97)00238-x · Cited by 135 · see citing works
Leineweber, C., Kecklund, G., Janszky, I., Åkerstedt, T., & Orth‐Gomér, K. (2003) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(02)00475-0 · Cited by 131 · see citing works
Self-citationFRIEDMAN, G. D., Ury, H. K., Klatsky, A. L., & SIEGELAUB, A. B. (1974) · Psychosomatic Medicine · doi:10.1097/00006842-197407000-00007 · Cited by 65 · see citing works
Are sleep complaints predictive of future myocardial infarction?
Appels, A., VOS, Y. D., van Diest, R., Höppner, P., Mulder, P., & de Groen, J. H. M. (1987) · PubMed · Cited by 57 · see citing works
Sleep physiological characteristics of exhausted men.
van Diest, R., & Appels, W. P. (1994) · Psychosomatic Medicine · doi:10.1097/00006842-199401000-00004 · Cited by 56 · see citing works
Siegrist, J., Peter, R., Motz, W., & Strauer, B. E. (1992) · European Heart Journal · doi:10.1093/eurheartj/13.suppl_d.89 · Cited by 55 · see citing works
Grimaldi, S., Partonen, T., Haukka, J. K., Aromaa, A., & Lönnqvist, J. K. (2009) · Nordic Journal of Psychiatry · doi:10.1080/08039480902878729 · Cited by 45 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
European guideline for the diagnosis and treatment of insomnia
Riemann, D., Baglioni, C., Bassetti, C., Bjorvatn, B., Dolenc Groselj, L., Ellis, J. G., Espie, C. A., Garcia‐Borreguero, D., Gjerstad, M., Gonçalves, M., et al. (2017) · Journal of Sleep Research · doi:10.1111/jsr.12594 · Cited by 2,049 · see citing works
St-Onge, M.-P., Grandner, M. A., Brown, D., Conroy, M. B., Jean-Louis, G., Coons, M., & Bhatt, D. L. (2016) · Circulation · doi:10.1161/cir.0000000000000444 · Cited by 1,044 · see citing works
Morin, C. M., & Jarrin, D. C. (2022) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2022.03.003 · Cited by 907 · see citing works
Shift work and vascular events: systematic review and meta-analysis
Vyas, M. V., Garg, A. X., Iansavichus, A. V., Costella, J., Donner, A., Laugsand, L. E., Janszky, I., Mrkobrada, M., Parraga, G., & Hackam, D. G. (2012) · BMJ · doi:10.1136/bmj.e4800 · Cited by 840 · see citing works
Self-citationInsomnia with objective short sleep duration: The most biologically severe phenotype of the disorder
Vgontzas, A. N., Fernandez-Mendoza, J., Liao, D., & Bixler, E. O. (2013) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2012.09.005 · Cited by 776 · see citing works
Insomnia and risk of cardiovascular disease: a meta-analysis
Sofi, F., Cesari, F., Casini, A., Macchi, C., Abbate, R., & Gensini, G. F. (2014) · European Journal of Preventive Cardiology · doi:10.1177/2047487312460020 · Cited by 713 · see citing works
Zachariae, R., Lyby, M. S., Ritterband, L. M., & O'Toole, M. S. (2016) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2015.10.004 · Cited by 704 · see citing works
“[6] Laugsand LE, Vatten LJ, Platou C, Janszky I.”
BackgroundCognitive and behavioral therapies in the treatment of insomnia: A meta-analysis
van Straten, A., van der Zweerde, T., Kleiboer, A., Cuijpers, P., Morin, C. M., & Lancee, J. (2018) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2017.02.001 · Cited by 676 · see citing works
Circadian rhythms and the molecular clock in cardiovascular biology and disease
Crnko, S., Du Pré, B. C., Sluijter, J. P. G., & Van Laake, L. W. (2019) · Nature Reviews Cardiology · doi:10.1038/s41569-019-0167-4 · Cited by 499 · see citing works
Sleep Apnea and Cardiovascular Disease: Lessons From Recent Trials and Need for Team Science
Drager, L. F., McEvoy, R. D., Barbe, F., Lorenzi-Filho, G., & Redline, S. (2017) · Circulation · doi:10.1161/circulationaha.117.029400 · Cited by 465 · see citing works
De Crescenzo, F., D'Alò, G. L., Ostinelli, E. G., Ciabattini, M., Di Franco, V., Watanabe, N., Kurtulmus, A., Tomlinson, A., Mitrova, Z., Foti, F., et al. (2022) · The Lancet · doi:10.1016/s0140-6736(22)00878-9 · Cited by 446 · see citing works
Trends in insomnia and excessive daytime sleepiness among US adults from 2002 to 2012
Ford, E. S., Cunningham, T. J., Giles, W. H., & Croft, J. B. (2015) · Sleep Medicine · doi:10.1016/j.sleep.2014.12.008 · Cited by 332 · see citing works
Exercise can improve sleep quality: A systematic review and meta-analysis
Banno, M., Harada, Y., Taniguchi, M., Tobita, R., Tsujimoto, H., Tsujimoto, Y., Kataoka, Y., & Noda, A. (2018) · PeerJ · doi:10.7717/peerj.5172 · Cited by 246 · see citing works
Insomnia and risk of cardiovascular disease: a meta-analysis of cohort studies
Li, M., Zhang, X.-W., Hou, W.-S., & Tang, Z.-Y. (2014) · International Journal of Cardiology · doi:10.1016/j.ijcard.2014.07.284 · Cited by 201 · see citing works
Cognitive behavioral treatment of insomnia
Williams, J., Roth, A., Vatthauer, K., & McCrae, C. S. (2013) · Chest · doi:10.1378/chest.12-0731 · Cited by 123 · see citing works
I keep a close watch on this heart of mine: increased interoception in insomnia
Wei, Y., Ramautar, J. R., Colombo, M. A., Stoffers, D., Gómez-Herrero, G., van der Meijden, W. P., te Lindert, B. H. W., van der Werf, Y. D., & Van Someren, E. J. W. (2016) · Sleep · doi:10.5665/sleep.6308 · Cited by 90 · see citing works
Canivet, C., Nilsson, P. M., Lindeberg, S. I., Karasek, R., & Östergren, P.-O. (2014) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2014.02.001 · Cited by 78 · see citing works
Strand, L. B., Laugsand, L. E., Wisløff, U., Nes, B. M., Vatten, L., & Janszky, I. (2013) · SLEEP · doi:10.5665/sleep.2310 · Cited by 79 · see citing works
Self-citationPaulos-Guarnieri, L., Linares, I. M. P., & El Rafihi-Ferreira, R. (2022) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2021.11.001 · Cited by 48 · see citing works
- Authors
- Laugsand, L. E., Vatten, L. J., Platou, C., & Janszky, I.
- Affiliations
- Norwegian University of Science and Technology (NO)
- ORCID
- Vatten, Lars J.
- Venue
- Circulation
- Published
- 2011-11-08
- Volume
- 124
- Issue
- 19
- Pages
- 2073-2081
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2164839923
- Cited by
- 438
- References
- 37
- Citations by year
- 2026: 16 · 2025: 23 · 2024: 40 · 2023: 22 · 2022: 32 · 2021: 31 · 2020: 25 · 2019: 32 · 2018: 22 · 2017: 34 · 2016: 42 · 2015: 35 · 2014: 31 · 2013: 31 · 2012: 19
- FWCI
- 34.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- insomnia, acute myocardial infarction, sleep disorders, difficulty initiating sleep, difficulty maintaining sleep, non-restorative sleep, coronary heart disease risk, dose-response relationship
- MeSH terms
- Adult, Aged, Anxiety, Chronic Disease, Depression, Female, Follow-Up Studies, Health Surveys, Heart Rate, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Myocardial Infarction, Norway, Risk Factors, Stress, Psychological, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
