Insomnia disorders are associated with increased cardiometabolic disturbances and death risks from cardiovascular diseases in psychiatric patients treated with weight-gain-inducing psychotropic drugs: results from a Swiss cohort

• Published in: BMC psychiatry 2022-05, Vol.22 (1), p.342-12, Article 342
• Main Authors: Laaboub, Nermine, Dubath, Céline, Ranjbar, Setareh, Sibailly, Guibet, Grosu, Claire, Piras, Marianna, Délessert, Didier, Richard-Lepouriel, Hélène, Ansermot, Nicolas, Crettol, Severine, Vandenberghe, Frederik, Grandjean, Carole, Delacrétaz, Aurélie, Gamma, Franziska, Plessen, Kerstin Jessica, von Gunten, Armin, Conus, Philippe, Eap, Chin B
• Format: Article
• Language: English
• Subjects: Anesthesia; Body mass index; Body weight gain; Cardiovascular diseases; Cardiovascular Diseases - chemically induced; Cardiovascular Diseases - epidemiology; Causes of; Cholesterol; Clozapine; Complications and side effects; Death; Demographic aspects; Diabetes; Diabetes mellitus; Drug dosages; Drug therapy; Female; Health aspects; High density lipoprotein; Hospitals; Humans; Hyperglycemia; Hypertension; Hypocholesterolemia; Insomnia; Insomnia disorders; Investigations; Male; Metabolic syndrome; Metabolic Syndrome - chemically induced; Metabolic Syndrome - complications; Metabolic Syndrome - epidemiology; Metabolic worsening; Metabolism; Mortality; Obesity; Olanzapine; Patients; Population; Prescription drugs; Prospective Studies; Psychiatric patients; Psychiatry; Psychotropic drugs; Psychotropic Drugs - adverse effects; Risk factors; Sedatives; Sleep disorders; Sleep Initiation and Maintenance Disorders; Switzerland - epidemiology; Valproic acid; Weight Gain
• ISSN: 1471-244X; 1471-244X
• DOI: 10.1186/s12888-022-03983-3

Insomnia disorders as well as cardiometabolic disorders are highly prevalent in the psychiatric population compared to the general population. We aimed to investigate their association and evolution over time in a Swiss psychiatric cohort. Data for 2861 patients (8954 observations) were obtained from two prospective cohorts (PsyMetab and PsyClin) with metabolic parameters monitored routinely during psychotropic treatment. Insomnia disorders were based on the presence of ICD-10 "F51.0" diagnosis (non-organic insomnia), the prescription of sedatives before bedtime or the discharge letter. Metabolic syndrome was defined using the International Diabetes Federation definition, while the 10-year risk of cardiovascular event or death was assessed using the Framingham Risk Score and the Systematic Coronary Risk Estimation, respectively. Insomnia disorders were observed in 30% of the cohort, who were older, predominantly female, used more psychotropic drugs carrying risk of high weight gain (olanzapine, clozapine, valproate) and were more prone to suffer from schizoaffective or bipolar disorders. Multivariate analyses showed that patients with high body mass index (OR = 2.02, 95%CI [1.51-2.72] for each ten-kg/m increase), central obesity (OR = 2.20, [1.63-2.96]), hypertension (OR = 1.86, [1.23-2.81]), hyperglycemia (OR = 3.70, [2.16-6.33]), high density lipoprotein hypocholesterolemia in women (OR = 1.51, [1.17-1.95]), metabolic syndrome (OR = 1.84, [1.16-2.92]) and higher 10-year risk of death from cardiovascular diseases (OR = 1.34, [1.17-1.53]) were more likely to have insomnia disorders. Time and insomnia disorders were associated with a deterioration of cardiometabolic parameters. Insomnia disorders are significantly associated with metabolic worsening and risk of death from cardiovascular diseases in psychiatric patients.