Clinically Diagnosed Insomnia and Risk of All-Cause and Diagnosis-Specific Disability Pension: A Nationwide Cohort Study
Table 2
Total cohort. Insomnia and risk of all-cause incident disability pension (DP), Swedish nationwide cohort study; follow-up, 2006–2010a.
In-/outpatient care with diagnoses of disorders of initiating and maintaining sleep (ICD-10: G 47.0)
No. of participants (%)
Person-years
No. of DPs
Crude IRR (95% CI)
Adjusted IRR (95% CI)b
Adjusted IRR (95% CI)c
Adjusted IRR (95% CI)d
Adjusted IRR (95% CI)e
Insomnia inpatient care (G47.0 main diagnosis)
0 admissions/hospitalization due to insomnia, 2000–2005 (unexposed)
4,980,748 (100.00)
23,560,231
137,370
1.00 (reference)
1.00 (reference)
1.00 (reference)
1.00 (reference)
1.00 (reference)
At least one admission due to insomnia, 2000–2005
134 (0.00)
584
19
5.29 (3.38–8.30)
1.34 (0.86–2.10)
1.30 (0.83–2.04)
1.20 (1.18–1.21)
0.79 (0.50–1.23)
Insomnia inpatient care (G47.0 secondary diagnosis)
0 admissions/hospitalization due to insomnia, 2000–2005 (unexposed)
4,980,799 (100.00)
23,560,431
137,382
1.00 (reference)
1.00 (reference)
1.00 (reference)
1.00 (reference)
1.00 (reference)
At least one admission due to insomnia, 2000–2005
83 (0.00)
384
7
3.10 (1.49–6.45)
0.94 (0.45–1.97)
1.18 (0.56–2.47)
0.98 (0.47–2.05)
0.70 (0.33–1.47)
Insomnia outpatient care (G47.0 main diagnosis)
0 specialist visits due to insomnia, 2001–2005 (unexposed)
4,980,552 (99.99)
23,559,370
137,348
1.00 (reference)
1.00 (reference)
1.00 (reference)
1.00 (reference)
1.00 (reference)
At least one specialist visit due to insomnia, 2001–2005
330 (0.01)
1,445
41
4.70 (3.47–6.37)
1.30 (0.96–1.76)
1.33 (0.98–1.80)
1.17 (0.86–1.58)
0.83 (0.61–1.12)
Insomnia outpatient care (G47.0 secondary diagnosis)
0 specialist visits due to insomnia, 2001–2005 (unexposed)
4,980,743 (100.00)
23,560,223
137,367
1.00 (reference)
1.00 (reference)
1.00 (reference)
1.00 (reference)
1.00 (reference)
At least one specialist visit due to insomnia, 2001–2005
139 (0.00)
591
22
6.14 (4.05–9.31)
1.89 (1.24–2.87)
2.22 (1.46–3.36)
1.97 (1.30–2.99)
1.50 (0.99–2.27)
Insomnia in-/outpatient care (G47.0 main/secondary diagnosis)
0 admissions/visits due to insomnia, 2000/2001–2005 (unexposed)
4,980,251 (99.99)
23,558,071
137,304
1.00 (reference)
1.00 (reference)
1.00 (reference)
1.00 (reference)
1.00 (reference)
At least one admission/visit due to insomnia, 2000/2001–2005
631 (0.01)
2,744
85
5.08 (4.11–6.28)
1.47 (1.19–1.82)
1.52 (1.23–1.88)
1.35 (1.09–1.67)
0.96 (0.78–1.19)
Total
4,980,882
23,560,815
137,389
The numbers of participants, person-years, and incident DPs are from the adjusted models where missing observations were excluded. In the crude models the number of missing observations = 0. The small number of missing observations for education, family situation, and country of birth is shown in Table 1. IRRs adjusted for prior sickness absence. IRRs adjusted for prior sickness absence, age, sex, education, and region of residence. IRRs adjusted for prior sickness absence, age, sex, education, region of residence, inpatient care, and specialized outpatient care. IRRs adjusted for prior sickness absence, age, sex, education, region of residence, inpatient care, specialized outpatient care, and medications (i.e., antipsychotics, anxiolytics, hypnotics, and sedatives).
