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. 2022 Jul 14:13:939251.
doi: 10.3389/fendo.2022.939251. eCollection 2022.

Association Between Diabetic Retinopathy and Insomnia Risk: A Nationwide Population-Based Study

Yoo Hyun Um  1 , Tae-Won Kim  1 , Jong-Hyun Jeong  1 , Seung-Chul Hong  1 , Ho-Jun Seo  1 , Kyung-Do Han  2
Affiliations

Association Between Diabetic Retinopathy and Insomnia Risk: A Nationwide Population-Based Study

Yoo Hyun Um et al. Front Endocrinol (Lausanne). .

Abstract

Background: Previous studies have suggested a close link between sleep disturbances and diabetic retinopathy (DR). However, to date, no confirmatory findings have been reported. We aimed to explore the risk of insomnia in DR by considering demographic factors and diabetes mellitus (DM)-related variables.

Methods: A nationwide population-based cohort of 2,206,619 patients with type 2 diabetes from the Korean National Insurance Service Database was followed up for insomnia incidence. DR, non-proliferative DR (NPDR), and proliferative DR (PDR) were defined according to ICD-10 codes. The interactive effects of sex, age, and DM-related variables were analyzed to evaluate their impact on insomnia risk in DR.

Results: Compared with the non-DR group, insomnia risk was increased in the DR [(adjusted hazard ratio (aHR): 1.125, 95% confidence interval (CI):1.108-1.142), NPDR (aHR:1.117, 95% CI:1.099-1.134), and PDR (aHR:1.205, 95% CI: 1.156-1.256), even after controlling for comorbidities, lifestyle factors, and DM-related variables. The men and youngest age groups (<40 years) were most vulnerable to insomnia risk. Sex, age, DM duration, and chronic kidney disease (CKD) status exerted interactive effects with DR status in increasing the insomnia risk. In the PDR group, sex, age, DM duration, insulin therapy status, and CKD status exerted interactive effects that increased the risk of insomnia.

Conclusion: Insomnia risk is significantly higher in patients with DR, and clinical attention is warranted.

Keywords: diabetes mellitus; hazard ratio; insomnia; retinopathy; risk.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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