Increased risk for sleep disorders in burn patients: A 14-year nationwide, population-based cohort study

Burns. 2021 Sep;47(6):1408-1415. doi: 10.1016/j.burns.2020.11.012. Epub 2020 Dec 9.

Abstract

Background: Burn is a major trauma that causes physical and psychosocial impairments, leading to sleep disorders. However, the data about risks for sleep disorders in patients over 3 years following burn injury are limited.

Aim: To investigate the long-term risks for sleep disorders in patients after burn injury and identify the high-risk population.

Methods: A 14-year population-based cohort study was performed using data from the 2000-2013 Taiwan National Health Insurance Research Database (NHIRD) which was a valid representative sample of the total population. All diagnoses of medical records in NHIRD were made by physicians and coded according to the ICD-9-CM. Cases diagnosed with burns (ICD-9 CM: N-code 940-949 and E-code 890-899) were included. The control group (non-burn injury group) was comprised quadruple the number of cases matched by index date, sex and age.

Results: In 2000-2013, among the 10,289 burn patients included and followed-up after the index year, burn injury significantly increased the risks for sleep disorders (Hazard Ratio; HR = 1.36, p = 0.044), including insomnia (HR = 1.41, p = 0.036), sleep disturbance (HR = 2.39, p = 0.005) and sleep apnoea (HR = 1.38, p = 0.029). Compared with the control group, those who were women (HR = 1.73, p = 0.021), adolescents (HR = 5.45, p < 0.001), aged 19-24 years (HR = 1.36, p = 0.034), aged 25-44 years (HR = 1.67, p = 0.007), had low income (HR = 2.14, p = 0.001), and without a history of mental disorders (HR = 1.41, p = 0.024) had significantly higher risks for developing sleep disorders when suffered burn injury.

Conclusion: Burn had long-term negative effects on sleep during both the first year of burn injury and the subsequent follow-up 14 years. It is important for physicians to long-term assess the sleep quality of burn patients regardless of the number of years after burn injury.

Keywords: Adolescents; Burn; Long-term effect; Population-based database; Sleep disorders; Women.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Burns* / epidemiology
  • Female
  • Humans
  • Incidence
  • Male
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Sleep Quality*
  • Sleep Wake Disorders* / epidemiology
  • Sleep Wake Disorders* / etiology
  • Taiwan / epidemiology
  • Young Adult