Are symptoms of insomnia related to respiratory symptoms? Cross-sectional results from 10 European countries and Australia.

• Published in: BMJ Open
• Main Authors: Bjornsdottir, Erla, Lindberg, Eva, Benediktsdottir, Bryndis, Gislason, Thorarinn, Garcia Larsen, Vanessa, Franklin, Karl, Jarvis, Debbie, Demoly, Pascal, Perret, Jennifer L, Garcia Aymerich, Judith, Arenas, Sandra Dorado, Heinrich, Joachim, Torén, Kjell, Jögi, Rain, Janson, Christer
• Other Authors: 1Haskolinn i Reykjavik, Reykjavik, Iceland [e-mail]. 2Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland. 3Respiratory Medicine and Allegology, Uppsala University, Uppsala, Sweden. 4Department of Respiratory Medicine and Sleep, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland. 5Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. 6Department of Surgery, Surgical and Perioperative Sciences, Umeå, Sweden. 7Department of Respiratory Epidemiology and Public Health, Imperial College, London, UK. 8Pneumology Department, University Hospital of Montpellier, Montpellier, France. 9University of Melbourne, Melbourne, Victoria, Australia. 10Centre for Research in Environmental Epidemiology (CREAL), Instituto de Salud Global Barcelona, Barcelona, Catalunya, Spain. 11Pulmonology Department, Hospital Galdakao-Usansolo, Galdacano, País Vasco, Spain. 12Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Clinical Center, Ludwig Maximilians University, Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Muenchen, Germany. 13Department of Occupational and Environmental Medicine, University of Gothenburg, Gothenburg, Sweden. 14Tartu University, Tartu, Estonia. 15Department of Respiratory Medicine, Uppsala University, Uppsala, Sweden.
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMJ Publishing Group 2020
• Subjects: insomnia; respiratory symptoms; sleep medicine; Svefntruflanir; Öndunarfærasjúkdómar; Sleep Initiation and Maintenance Disorders; Signs and Symptoms; Respiratory; Iceland
• Online Access: http://hdl.handle.net/2336/621467; https://doi.org/10.1136/bmjopen-2019-032511

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Download Objectives: To compare the prevalence of different insomnia subtypes among middle-aged adults from Europe and Australia and to explore the cross-sectional relationship between insomnia subtypes, respiratory symptoms and lung function. Design: Cross-sectional population-based, multicentre cohort study. Setting: 23 centres in 10 European countries and Australia. Methods: We included 5800 participants in the third follow-up of the European Community Respiratory Health Survey III (ECRHS III) who answered three questions on insomnia symptoms: difficulties falling asleep (initial insomnia), waking up often during the night (middle insomnia) and waking up early in the morning and not being able to fall back asleep (late insomnia). They also answered questions on smoking, general health and chronic diseases and had the following lung function measurements: forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and the FEV1/FVC ratio. Changes in lung function since ECRHS I about 20 years earlier were also analysed. Main outcome measures: Prevalence of insomnia subtypes and relationship to respiratory symptoms and function. Results: Overall, middle insomnia (31.2%) was the most common subtype followed by late insomnia (14.2%) and initial insomnia (11.2%). The highest reported prevalence of middle insomnia was found in Iceland (37.2%) and the lowest in Australia (22.7%), while the prevalence of initial and late insomnia was highest in Spain (16.0% and 19.7%, respectively) and lowest in Denmark (4.6% and 9.2%, respectively). All subtypes of insomnia were associated with significantly higher reported prevalence of respiratory symptoms. Only isolated initial insomnia was associated with lower FEV1, whereas no association was found between insomnia and low FEV1/FVC ratio or decline in lung function. Conclusion: There is considerable ...