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Author Laugsand, L.E.; Vatten, L.J.; Bjorngaard, J.H.; Hveem, K.; Janszky, I. url  doi
  Title Insomnia and high-sensitivity C-reactive protein: the HUNT study, Norway Type Journal Article
  Year 2012 Publication Psychosomatic Medicine Abbreviated Journal Psychosom Med  
  Volume 74 Issue 5 Pages 543-553  
  Keywords Adult; Age Factors; Aged; C-Reactive Protein/analysis/*metabolism; Chronic Pain/epidemiology; Coronary Disease/*epidemiology; Epidemiologic Methods; Female; Humans; Inflammation/epidemiology/*metabolism; Male; Middle Aged; Norway/epidemiology; Psychiatric Status Rating Scales; Sex Distribution; Sleep Initiation and Maintenance Disorders/*epidemiology/metabolism; Stress, Psychological/epidemiology; Young Adult  
  Abstract OBJECTIVE: To explore the hypothesis that insomnia may increase the risk of coronary heart disease through inflammatory mechanisms. METHODS: The association of high-sensitivity C-reactive protein (hsCRP) with self-reported symptoms of insomnia was examined. Participants were 8547 men and nonpregnant women who answered one or more insomnia-related questions and who had available hsCRP measurements in the Nord-Trondelag Health Study. In multivariable linear regression analyses of the logarithm of hsCRP, we adjusted for established cardiovascular risk factors, psychosocial distress, chronic pain, and chronic somatic disorders. RESULTS: Among men, difficulties initiating sleep and nonrestorative sleep were associated with increasing hsCRP levels after adjusting for age (B = 0.07, 95% confidence interval [CI] = 0.01-0.14, p for trend = .02 and B = 0.09, 95% CI = 0.02-0.15, p for trend = .006), but after multivariable adjustment, the associations were attenuated (B = 0.03, 95% CI = -0.03 to 0.09, p for trend = .30 and B = 0.06, 95% CI = -0.00 to 0.12, p for trend = .05). HsCRP was not associated with other insomnia-related symptoms. In women, there was no evidence for any association of symptoms of insomnia with hsCRP levels. Results indicated sex differences in the association between sleep characteristics and CRP (difficulties maintaining sleep, p interaction = .018; cumulative number of symptoms of insomnia, p interaction = .014; and symptoms of insomnia influencing work performance, p interaction = .039). CONCLUSIONS: There were no consistent associations between symptoms of insomnia and hsCRP levels. Our results do not support the hypothesis that inflammation, as reflected by elevated levels of hsCRP, is an important factor linking insomnia to coronary heart disease.  
  Address Department of Public Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, NO-7489, Norway. lars.e.laugsand@ntnu.no  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0033-3174 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:22685243 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1543  
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Author Sivertsen, B.; Salo, P.; Mykletun, A.; Hysing, M.; Pallesen, S.; Krokstad, S.; Nordhus, I.H.; Overland, S. url  doi
  Title The bidirectional association between depression and insomnia: the HUNT study Type Journal Article
  Year 2012 Publication Psychosomatic Medicine Abbreviated Journal Psychosom Med  
  Volume 74 Issue 7 Pages 758-765  
  Keywords Adult; Aged; Aged, 80 and over; Comorbidity; Depression/*epidemiology; Depressive Disorder/*epidemiology; Female; Humans; Male; Middle Aged; Norway/epidemiology; Odds Ratio; Prospective Studies; Questionnaires; Sleep Initiation and Maintenance Disorders/*epidemiology; Time Factors  
  Abstract OBJECTIVE: Depression and insomnia are closely linked, yet our understanding of their prospective relationships remains limited. The aim of the current study was to investigate the directionality of association between depression and insomnia. METHODS: Data were collected from a prospective population-based study comprising the most recent waves of the Nord-Trondelag Health Study (HUNT) (the HUNT2 in 1995-1997 and the HUNT3 in 2006-2008). A total of 24,715 persons provided valid responses on the relevant questionnaires from both surveys. Study outcomes were onset of depression or insomnia at HUNT3 in persons not reporting the other disorder in HUNT2. RESULTS: Both insomnia and depression significantly predicted the onset of the other disorder. Participants who did not have depression in HUNT2 but who had insomnia in both HUNT2 and HUNT3 had an odds ratio (OR) of 6.2 of developing depression at HUNT3. Participants who did not have insomnia in HUNT2 but who had depression in both HUNT2 and HUNT3 had an OR of 6.7 of developing insomnia at HUNT3. ORs were only slightly attenuated when adjusting for potential confounding factors. CONCLUSIONS: The results support a bidirectional relationship between insomnia and depression. This finding stands in contrast to the previous studies, which have mainly focused on insomnia as a risk factor for the onset of depression.  
  Address Division of Mental Health, Norwegian Institute of Public Health, Christiesgt 13, 5020 Bergen, Norway. borge.sivertsen@fhi.no  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0033-3174 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:22879427 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1574  
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Author Strand, L.B.; Laugsand, L.E.; Wisloff, U.; Nes, B.M.; Vatten, L.; Janszky, I. url  doi
  Title Insomnia symptoms and cardiorespiratory fitness in healthy individuals: the Nord-Trondelag Health Study (HUNT) Type Journal Article
  Year 2013 Publication Sleep Abbreviated Journal Sleep  
  Volume 36 Issue 1 Pages 99-108  
  Keywords *Cardiovascular Physiological Phenomena; Cross-Sectional Studies; Exercise/physiology; Exercise Test/methods; Female; Health Status; Health Surveys/*methods/statistics & numerical data; Humans; Male; Middle Aged; Norway/epidemiology; Oxygen Consumption/*physiology; Physical Fitness/*physiology; Questionnaires; *Respiratory Physiological Phenomena; Sleep Initiation and Maintenance Disorders/*epidemiology/*physiopathology  
  Abstract STUDY OBJECTIVES: Previous studies have found an inverse association between insomnia and self-reported physical activity, but it is not clear whether insomnia is associated with cardiorespiratory fitness. Our aim was to investigate different insomnia symptoms in relation to the gold standard measure of cardiorespiratory fitness, i.e., peak oxygen uptake (VO(2peak)). DESIGN: Cross-sectional population study. SETTING: Nord-Trondelag County, Norway. PARTICIPANTS: The group comprised 3,489 men and women who were free from cardiovascular or pulmonary diseases, cancer, and sarcoidosis and who did not use antihypertensive medication. They were included in the fully adjusted model when assessing all insomnia symptoms simultaneously. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: For insomnia, the participants reported how often they had experienced sleep problems during the past 3 months, including difficulties falling asleep at night, repeated awakenings during the night, early awakenings without being able to go back to sleep, and daytime sleepiness. Response options were “never/almost never,” “sometimes” or “several times a wk.” To measure cardiorespiratory fitness, the participants were asked to walk or run on a treadmill with increasing speed and/or incline until exhaustion, and VO(2peak) was recorded. We found a modest inverse and graded association of the insomnia symptoms with VO(2peak). The association was independent of self-reported physical activity and was apparent for all insomnia symptoms except for early awakenings. We found a dose-response relation for a cumulative combination of insomnia symptoms and VO(2peak) for experiencing zero, one to two, or three to four symptoms (P for trend < 0.001). CONCLUSIONS: We found a modest inverse association of insomnia with VO(2peak) independent of the conventional cardiovascular risk factors and self-reported physical activity.  
  Address Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway. linn.b.strand@ntnu.no  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0161-8105 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:23288976; PMC3524509 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1395  
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