Insomnia But Not Hypnotics Use Associates with the Risk of Breast Cancer: A Population-Based Matched Cohort Study

J Womens Health (Larchmt). 2018 Oct;27(10):1250-1256. doi: 10.1089/jwh.2017.6626. Epub 2018 Mar 12.

Abstract

Objective: The impact of hypnotic use on the association between insomnia and breast cancer risk remains unclear. This study examined whether insomnia increases the aforementioned risk and explored the effects of hypnotic use on this relationship.

Materials and methods: This retrospective cohort study was conducted using data retrieved from the Longitudinal Health Insurance Research Database 2010. In total, 11,021 patients with insomnia, who were categorized by hypnotic use and nonuse, were identified; 22,042 age-matched participants without insomnia were then randomly selected. Cox proportional hazards regression was used for the analyses.

Results: The insomnia cohort had a higher risk of breast cancer than did the control cohort (adjusted hazard ratio [aHR] = 1.43; 95% confidence interval [CI] = 1.10-1.84). The aHR was 1.09 for insomniac with hypnotics use, 1.41 for insomniac without hypnotics use, and 0.71 for hypnotics users without insomnia (95% CIs = 0.71-1.68, 1.07-1.85, and 0.40-1.27) compared with those individuals without insomnia who did not use hypnotics.

Conclusion: This nationwide population-based cohort study reveals that insomnia but not hypnotic use is associated with an increased risk of breast cancer.

Keywords: breast cancer; hypnotic use; insomnia.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Breast Neoplasms / epidemiology*
  • Cohort Studies
  • Databases, Factual
  • Female
  • Humans
  • Hypnotics and Sedatives / therapeutic use*
  • Middle Aged
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Assessment / statistics & numerical data
  • Risk Factors
  • Sleep Initiation and Maintenance Disorders* / drug therapy
  • Sleep Initiation and Maintenance Disorders* / epidemiology
  • Taiwan / epidemiology

Substances

  • Hypnotics and Sedatives