Insomnia and Incident Cardiovascular Disease in US Hispanic/Latino Adults: Results From HCHS/SOL

Insomnia has been recognized as an independent cardiovascular risk factor, but longitudinal evidence remains limited.

We analyzed data from 3635 participants in the HCHS/SOL (Hispanic Community Health Study/Study of Latinos). Insomnia was assessed at baseline using the Women's Health Initiative Insomnia Rating Scale and evaluated by insomnia group status, symptom severity, specific symptom dimensions, and sleep duration. The primary outcome was incident cardiovascular disease (CVD) over a median follow-up of 6.05 years, defined using Framingham composite criteria. Cox proportional hazards models were used to estimate adjusted hazard ratio (HR) and 95% CI. Subgroup and interaction analyses examined effect modification by age and sex.

Insomnia was independently associated with a 78% increased risk of incident CVD (HR, 1.78 [95% CI, 1.02-3.12], P<0.05). The association was significant in men (HR, 2.48 [95% CI, 1.44-4.28], P<0.01) and adults aged ≤60 years (HR, 2.03 [95% CI, 1.06-3.87], P<0.05) but not in women or older individuals. Each 1-point increase in Women's Health Initiative Insomnia Rating Scale score was associated with a 5% higher hazard of CVD. And the early morning awakening showed the significant associations with CVD risk.

This study first demonstrates a prospective link between insomnia and incident CVD in a large cohort of US Hispanic/Latino adults. Baseline insomnia conferred an increased risk of developing CVD, particularly among men and younger adults. Early morning awakening drove most of this association, underscoring the need for targeted sleep interventions in this population.