Insomnia

Abnormal sleep (including insomnia) is self-reported by more than 50% of adults older than 65 years and by over 60% of nursing home residents 1) 2) 3).


To assess the prevalence and related factors of a newly developed insomnia disorder following craniotomy for brain tumor resection. Furthermore, we examined the association of pre-and postoperative insomnia with the 2-year mortality rate.

The South Korean national registration cohort database was used as the data source. This study includes all adult patients who underwent craniotomy for brain tumor resection from January 1, 2011, to December 31, 2017. G47.0 and F51.0 (International Statistical Classification of Diseases and Related Health Problems 10th Revision codes) were used to identify insomnia disorders.

In total, 4,851 patients were included. Among them, 913 (18.8%) and 447 (9.2%) patients were assigned to the preoperative and postoperative insomnia groups, respectively. After modeling using multivariable logistic regression, older age (odds ratio (OR) 1.02, 95% confidence interval (CI) 1.01-1.03; P < 0.001), reoperation within 1 year (OR 2.12, 95% CI 1.47-3.06; P < 0.001), and newly acquired brain disability (OR 1.32, 95% CI 1.01-1.71; P = 0.043) were associated with an increased prevalence of newly developed postoperative insomnia disorder. After modeling using multivariable Cox regression, the preoperative and postoperative insomnia disorder groups showed a 1.17-fold (hazard ratio (HR) 1.17, 95% CI 1.02-1.34; P = 0.021) and a 1.85-fold (HR 1.85, 95% CI 1.59-2.15, P < 0.001) increased 2-year all-cause mortality risk compared to the control group, respectively.

In South Korea, 9.2% of the patients with brain tumors were newly diagnosed with an insomnia disorder following craniotomy for brain tumor resection, which was associated with an increased risk of 2-year mortality 4).


Alcohol withdrawal syndrome.

Delirium tremens


1)
V.R. Porter, W.G. Buxton, A.Y. Avidan, Sleep, cognition and dementia. Curr. Psychiatry Rep. 7 (2015) 97. doi. 10.1007/s11920-015-0631-8
2)
G. Cipriani, C. Lucetti, S. Danti, A. Nuti, Sleep disturbances and dementia. Psychogeriatrics 15 (2015) 65–74.
3)
N. Gosselin, A.A. Baril, R.S. Osorio, M. Kaminska, J. Carrier J, Obstructive sleep apnea and the risk of cognitive decline in older adults. Am. J. Respir. Crit. Care Med. (2018) doi: 10.1164/rccm.201801-0204PP
4)
Choi HR, Song IA, Park HY, Oh TK. Association between insomnia disorder and mortality among patients who underwent craniotomy for brain tumor resection: a South Korean nationwide cohort study. Sleep Breath. 2022 Feb 24. doi: 10.1007/s11325-022-02586-2. Epub ahead of print. PMID: 35199289.
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