Written by Angeline A. De Leon, Staff Writer. Analyses of questionnaires completed by 423 participating Korean women found that the most severe insomnia was positively correlated with depressive symptoms, higher stress, and more screen time while total and LDL cholesterols were significantly higher in women with insomnia.
Clinically, insomnia is characterized by persistent difficulty in falling and staying asleep. In addition to increasing risk of anxiety, depression, and obesity, chronic insomnia is associated with lower quality of life 1 and greater risk of hypertension and heart disease 2. The mechanism linking insomnia to cardiovascular disease (CVD) is not yet clear, however, it is believed that increased sympathetic nervous system activity as a result of disrupted sleep may play a role in causing coronary dysfunction 3. The risk factors for insomnia are varied and complicated, with studies pointing to hormonal alterations 4, dysfunctional beliefs about sleep 5, and even educational attainment 6 as being associated with insomnia. What also stands out is a clear gender-related difference in the prevalence of insomnia, evidenced by greater overall susceptibility to sleep disturbance and higher rates of insomnia among women, specifically 54% of post-menopausal women 7. Considering a multi-dimensional approach to studying sleep quality, researchers in Korea (2017) examined the collective impact of personal, behavioral, and socio-environmental factors on the sleep characteristics of women with insomnia and their potential relation to CVD.
In a non-experimental, cross-sectional, population-based study, a sample of 423 Korean women (mean age = 55 years) were recruited for participation. A number of self-report measures were administered to assess sleeping habits (severity of insomnia, sleep quality), personal characteristics (age, income, education, employment), behavioral characteristics (fitness level, alcohol consumption, TV/video and computer screen time, coffee intake), and socio-environmental characteristics (subjective stress, emotional support). BMI was measured, and serum glucose and lipids were analyzed based on fasting blood samples.
Analysis of the data revealed that greater severity of insomnia was positively associated with more depressive symptoms (p < 0.001), higher stress (p < 0.01), more screen time (3 or more hours/day) (p < 0.05), and a lower education level (middle school or lower) (p < 0.05). In women with insomnia, total cholesterol and LDL cholesterol were significantly higher (p < 0.05), and BMI was found to be higher in the poor sleep quality group vs. the normal sleep group (p < 0.05).
While stress has long been regarded as the primary cause of insomnia and poor sleep quality, this study provides evidence to suggest that a broader spectrum of factors is involved in the development of sleep disturbance. In addition to symptoms of depression and anxiety, behavioral habits like screen time may play a role in sleep quality. Evidence also confirms the relationship between poor sleep and higher risk of CVD, calling for a more multifactorial approach to the treatment of insomnia and potential prevention of heart disease, especially in women. Future studies employing a randomized trial design are warranted.
Source: Ham, Ok Kyung, Jinyoung Kim, Bo Gyeong Lee, and Eunju Choi. “Behavioral Characteristics and Cardiovascular Disease Risks Associated With Insomnia and Sleep Quality Among Middle‐Aged Women in South Korea.” Research in nursing & health 40, no. 3 (2017): 206-217.
© 2017 Wiley Periodicals, Inc.
Posted August 24, 2017.
Angeline A. De Leon, MA, graduated from the University of Illinois at Urbana-Champaign in 2010, completing a bachelor’s degree in psychology, with a concentration in neuroscience. She received her master’s degree from The Ohio State University in 2013, where she studied clinical neuroscience within an integrative health program. Her specialized area of research involves the complementary use of neuroimaging and neuropsychology-based methodologies to examine how lifestyle factors, such as physical activity and meditation, can influence brain plasticity and enhance overall connectivity.
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- Cuadros JL, Fernández-Alonso AM, Cuadros-Celorrio ÁM, et al. Perceived stress, insomnia and related factors in women around the menopause. Maturitas. 2012;72(4):367-372.
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