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Healing
ARDS survivors at elevated danger for insomnia 1 yr after prognosis
22
Jun
Jun
Source/Disclosures
Disclosures:
Oh reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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One year after diagnosis, 12.6% of acute respiratory distress syndrome survivors in South Korea received a new diagnosis of insomnia, researchers reported in Annals of the American Thoracic Society.
“As the most common type of sleep disorder, insomnia can occur in survivors of critical illnesses, and it is related to poor quality of life. The prevalence of insomnia was reported to be 28% at the 1-year follow-up of patients after ICU discharge,” Tak Kyu Oh, MD, of the department of anesthesiology and pain medicine at the College of Medicine at Seoul National University in South Korea, and colleagues wrote. “Moreover, 73% of ARDS survivors have neurocognitive sequelae, which can co-occur with insomnia disorder.”
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Researchers used the National Health Insurance Database of South Korea to identify 4,452 adults (mean age, 62.9 years; 59.7% men) who were admitted to the ICU for ARDS from January 2010 to December 2018, all of whom survived for at least 1 year after diagnosis.
ARDS survivors who received an insomnia diagnosis prior to ARDS were categorized as the pre-ARDS insomnia disorder group (n = 895) and those with no insomnia history who received a new insomnia diagnosis within 1 year of ARDS diagnosis were categorized as the post-ARDS insomnia disorder group (n = 536).
According to study results, occurrence of delirium (OR = 1.61; 95% CI, 1.24-2.1), anxiety disorder (OR = 1.34; 95% CI, 1.08-1.66), depression (OR = 1.48; 95% CI, 1.17-1.86) and substance abuse (OR = 1.51; 95% CI, 1.01-2.26) were associated with a higher prevalence of post-ARDS insomnia disorder.
Further, pre-ARDS insomnia disorder was associated with a 1.33-fold increased prevalence of 2-year all-cause mortality among survivors of ARDS (HR = 1.33; 95% CI, 1.08-1.64), while post-ARDS insomnia disorder was associated with a 1.36-fold increase (HR = 1.36; 95% CI, 1.06-1.74).
“Our results suggested that ARDS survivors with insomnia disorder were a high-risk group that required treatments, such as medications, cognitive behavioral therapy or combination, before and after ARDS diagnoses,” the researchers wrote.
