JOEM: Interaction Effect of Shift Work and Insomnia on Stroke Risk: A 19-Year Prospective Cohort Study in Korea (September 2024)-Interaction Effect of Shift Work and Insomnia on Stroke Risk: A 19-Year Prospective Cohort Study in Korea

Interaction Effect of Shift Work and Insomnia on Stroke Risk: A 19-Year Prospective Cohort Study in Korea

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A 19-year prospective cohort study conducted in Korea investigated the interaction between shift work and insomnia on the risk of stroke. Utilizing data from the Korean Genome and Epidemiology Study (KoGES), the researchers analyzed 931 men and women aged 40–69 years. The primary exposures were shift work and insomnia, while the main outcome was the incidence of stroke. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox regression analysis.<br /><br />Key findings revealed that shift work significantly increased the risk of stroke, but only among individuals with insomnia, as indicated by a hazards ratio of 2.49 (95% CI, 1.02–6.11). Neither shift work nor insomnia alone were significantly associated with stroke incidence. Specifically, 174 new stroke cases were documented over an 18-year follow-up period, with a higher, though not statistically significant, stroke incidence observed in the shift work group (6.1%) compared to those not exposed to shift work (5.5%).<br /><br />Shift work, which disrupts natural circadian rhythms and has been linked to various health issues such as cardiovascular and metabolic disorders, shows compounded risks when concurrent with insomnia. Insomnia itself, marked by difficulty sleeping or non-restorative sleep, is prevalent among shift workers and worsens life quality and susceptibility to chronic conditions.<br /><br />The interaction analysis found that shift work combined with insomnia significantly increased stroke risk but did not have the same effect in individuals without insomnia. Thus, there is a synergistic effect between sleep disturbances and irregular work schedules on stroke risk.<br /><br />The study underscores the importance of considering individual sleep health in occupational risk assessments and suggests targeted interventions to mitigate stroke risk in populations affected by both shift work and insomnia. This study contributes to a deeper understanding of how occupational exposures and sleep health intersect, emphasizing the critical need for public health strategies focusing on high-risk groups.

Keywords

shift work

insomnia

stroke risk

Korean Genome and Epidemiology Study

KoGES

circadian rhythms

hazard ratios

Cox regression analysis

occupational risk

public health strategies