The Combination of Sleep Disorders and Depression Significantly Increases Cancer Risk: A Nationwide Large-Scale Population-Based Study

Fang-Chin Hsu; Chih-Hsiung Hsu; Chi-Hsiang Chung; Ta-Wei Pu; Pi-Kai Chang; Tzu-Chiao Lin; Shu-Wen Jao; Chao-Yang Chen; Wu-Chien Chien; Je-Ming Hu

doi:10.3390/ijerph19159266

The Combination of Sleep Disorders and Depression Significantly Increases Cancer Risk: A Nationwide Large-Scale Population-Based Study

Int J Environ Res Public Health. 2022 Jul 28;19(15):9266. doi: 10.3390/ijerph19159266.

Authors

Fang-Chin Hsu¹, Chih-Hsiung Hsu^{2

3}, Chi-Hsiang Chung^{4

5

6}, Ta-Wei Pu⁷, Pi-Kai Chang⁸, Tzu-Chiao Lin⁸, Shu-Wen Jao⁸, Chao-Yang Chen⁸, Wu-Chien Chien^{4

5

9}, Je-Ming Hu^{2

7

10}

Affiliations

¹ Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.
² Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 114, Taiwan.
³ Teaching Office, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.
⁴ School of Public Health, National Defense Medical Center, Taipei 114, Taiwan.
⁵ Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.
⁶ Taiwanese Injury Prevention and Safety Promotion Association, Taipei 114, Taiwan.
⁷ Division of Colon and Rectal Surgery, Department of Surgery, Songshan Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.
⁸ Division of Colorectal Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.
⁹ Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 114, Taiwan.
¹⁰ School of Medicine, National Defense Medical Center, Taipei 114, Taiwan.

Abstract

Introduction: Sleep disorders, depression, and cancer have become increasingly prevalent worldwide. However, it is unknown whether coexistence of sleep disorders and depression influences the risk of cancer development. Therefore, we conducted a nationwide population-based study to examine this association among patients in Taiwan. Materials and Methods: A total of 105,071 individuals diagnosed with cancer and 420,284 age- and sex-matched patients without a diagnosis of cancer between 2000 and 2015 were identified from Taiwan’s National Health Insurance Research Database. The underlying chronic diseases of patients that may developed cancer were gathered and studied as the predictor. A multivariate Cox proportional odds model was used to estimate the crude and adjusted odds ratios (aORs) with 95% confidence intervals (CIs) to estimate the interaction effect between sleep disorders and depression on the risk of cancer. Results: After adjusting for age, sex, comorbidities, and other covariates, the cancer group was associated with increased exposure to sleep disorders than the non-cancer group (aOR = 1.440, 95% CI = 1.392−1.489, p < 0.001). In addition, patients with both sleep disorders and depression were at an even higher risk for cancer than the general population (aOR = 6.857, p < 0.001). Conclusions: This retrospective cohort study shows that patients with both sleep disorders and depression are at a higher risk of cancer. Clinically, a meticulous cancer risk evaluation is recommended for patients with both sleep disorders and depression.

Keywords: cancer; depression; sleep disorder.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Depression / epidemiology
Humans
Incidence
Neoplasms* / complications
Neoplasms* / epidemiology
Proportional Hazards Models
Retrospective Studies
Risk Factors
Sleep Wake Disorders* / complications
Sleep Wake Disorders* / epidemiology
Taiwan / epidemiology

Grants and funding

This study was supported by the Tri-Service General Hospital Research Foundation (TSGH-B-111018), and the sponsor has no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.