ArticlemedRxiv : the preprint server for health sciences2025
Insomnia, sleep apnea, and incidence of hypertension and cardiovascular disease.
Article in medRxiv : the preprint server for health sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
- Updated by
Authors and funding
11 authors.
Funding
Abstract
Introduction: Comorbid insomnia and obstructive sleep apnea (OSA, i.e., COMISA) are associated with cardiovascular disease (CVD) among older adults. It is unknown how the comorbidity is related to cardiovascular risk among younger military Veterans, who show a greater risk for hypertension and CVD than non-Veterans, and if associations differ by sex. Thus, we examined whether COMISA is associated with incident hypertension and CVD risk in younger men and women Veterans. Methods: The cohort included post-9/11 Veterans who enrolled in Veterans Health Administration care from 2001 to 2021. Administrative and electronic health record data were merged. Insomnia and OSA were defined by 2 outpatient International Classification of Diseases, 9 or 10 diagnoses. Hypertension was defined by ≥2 outpatient-coded diagnoses or ≥1 antihypertensive medication fill. CVD was defined by 1≥ inpatient or ≥2 outpatient diagnoses. Time-varying Cox proportional hazard models were adjusted for demographics, behavioral, and clinical factors and conducted overall and by sex. Results: Analyses included 937,598 Veterans (12% women; median age: 41 years). Greater hypertension risk was observed overall (adjusted hazard ratio [aHR]:2.43: 95%CI:2.36-2.50), for men (aHR:2.09, 95%CI:2.02-2.16) and women with COMISA (aHR:2.20, 95%CI:2.00-2.42), insomnia only (aHRs:1.27-1.44), and OSA only (aHRs:2.00-2.26) versus no sleep disorder. For incident CVD, COMISA was again associated with risk overall (aHR:3.81, 95%CI:3.64-3.99), in men (aHR:3.81, 95%CI:3.63-4.00), and women (aHR:3.44, 95%CI:2.98-3.98), as were insomnia (aHRs:1.36-1.37) and OSA (aHRs:3.32-2.62). Conclusions: For post-9/11 Veterans, COMISA was associated with the greatest risk of hypertension and CVD. Identifying disordered sleep among men and women should be a cardiovascular prevention priority.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.