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Insomnia Linked to Premature Death in Men
  What Causes Premature Aging in HIV?
Less obvious are stressors, which HIV individuals often have more of; and, sleep: research published recently shows that HIV+ individuals have more trouble sleeping due to HIV and anxiety/depression/caffeine consumption, and other published papers show lack of sleep causes comorbidities to emerge sooner. Damaged mitochondria may accelerate aging.
Sleep and HIV illness.-
OBJECTIVE: To assess the severity and prevalence of sleep disturbances in patients attending an urban AIDS clinic and to determine the correlation to the
Incidence and severity of nervous system and psychiatric events ...
The most frequent psychiatric events were insomnia (7.2% vs 8.3%), depression ( 4.2% vs 6.6%), anxiety (3.8% vs 4.1%) and sleep disorder (1.3% vs 0.8%). ...
Psychological Stress and Disease (HIV/AIDS)
JAMA. Oct 10, 2007;298:1685-1687. ...stress modifies disease-relevant biological ...decreased exercise and sleep, and poorer adherence to medical regimens
Insomnia Linked to Premature Death in Men
MedPage Today
June 12, 2009
SEATTLE, June 12 -- Men have an increased risk of premature death if they have chronic insomnia along with a short sleep duration, researchers here said.
Action Points
* Explain to interested patients that this study suggests that sleep disorders may increase the risk of premature death in men.
* Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
In a longitudinal study of more than 1,700 men and women followed for more than 10 years, men with insomnia and short sleep duration were almost five times more likely to die than men who had normal sleep, said Alexandros N. Vgontzas, M.D., professor of psychiatry and director of the Sleep Research Center at Penn State University Milton S. Hershey Medical Center in Hershey, Pa.
Dr. Vgontzas reported the findings at the annual meeting of the Associated Professional Sleep Societies.
"Until now, most studies had failed to show that insomnia, like sleep apnea, is associated with medical morbidity and mortality," said Dr. Vgontzas.
But he added that insomnia was not an independent predictor of excess mortality. For the mortality risks of insomnia to be discernible, investigators needed to factor in sleep duration data, he said. Short sleep duration was defined as less than six hours uninterrupted sleep per night.
The mortality rate was worst for men with insomnia who slept either fewer than five hours per night, or five to six hours, with odds ratios of 4.51 and 5.0, respectively (95% CI 1.4 to 18.6 and 0.67 to 37.1, respectively).
The mortality difference for women with insomnia and a short sleep duration was not significantly different from that of all women in the group. The results were unchanged when the investigators adjusted for depression and sleep-disordered breathing.
Dr. Vgontzas and colleagues randomly selected 1,741 men and women living in Central Pennsylvania. All participants underwent testing in the investigators' sleep laboratory.
The researchers followed the men (N=741) for an average of 14 years and the women for 10 years. During follow-up 145 men (19.3%) died as did 103 (10.3%) of the women, he said.
The researchers relied on self-report for diagnosis of insomnia and polysomnography for objective evidence of sleep duration.
"The novel approach in our studies is that, besides the subjective report of the patient, we have used objective information as measured in our sleep laboratory," he said.
The investigators defined insomnia as lasting more than one year; they defined poor sleep as difficulty falling asleep or staying asleep, or as an excessively early final awakening.
They categorized the polysomnographic data regarding sleep duration into three categories: those with at least six hours of sleep per night, those who got five to six hours per night, and those who slept fewer than five hours per night.
The study was funded by the National Institutes of Health. Dr. Vgontzas said he had no financial disclosures with regard to this study.
Primary source: Association of Professional Sleep Societies
Source reference:
Vgontzas AN, et al "Insomnia with objective short sleep duration is associated with increased mortality in men" SLEEP 2009; 32: A283-4.
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