COMORBIDITY OF PSYCHIATRIC DISORDERS AND NON-COMMUNICABLE DISEASES IN SLEEP DISORDERS USING NDB MEDICAL BIG DATA
Authors: Ishii *Kazuo , Miyamoto Yuuma , Yoshinaga Yasunori , Sakagami Ryuji , Shoji Yoshihisa , Morikawa Nagisa , Nohara Yume , Nohara Shoichiro , Fukumoto Yoshihiro 
Published: February 2025

Abstract

Background
Disturbed lifestyle habits associated with sleep-w disorders is a major social problem in recent years. Especially, Japanese is recognized to have lesser of sleeping time in the world. Sleep-wake disorders are known to accompany with various diseases such as mental disorders and NCDs, worsening the quality of life.

Aims & Objectives
We have launched a comprehensive study to investigate the relationship between neuropsychiatric disorders and NCDs and the usage of prescription drugs, using NDB (National Database of Health Insurance Claims and Specific Health Checkups of Japan) established by the Ministry of Health, Labour and Welfare. In this study, our purpose was to investigate the comorbidities of psychiatric disorders and NCDs in sleep-wake disorders.

Method
This study was performed using the NDB sampling dataset, which is random-extracted subsets of NDB. The research subjects (Patients) were used Medical Non-Hospitalization Receipts and Prescription Receipts of NDB Sampling Data Set (January, April, July, and October in 2011-2019). For drug information, the Drug Code included in the Prescription Receipts was used. The investigated factors (Exposure) were used Disease Code; "sleep-wake disorder (ICD-10 code G47)'' in Medical Non- Hospitalization Receipt. As "Comparison" subject, medical claims with no disease code for sleep disorder (G47) of Medical Non-Hospitalization Receipt was used. For the Outcome, receipts with Disease Code of mental illnesses and NCDs were used. We extracted all data from each month of the NDB sampling dataset and calculated the monthly average. These results were evaluated using odds ratios, adjusted odds ratios, and chi-square tests. Odds ratios, adjusted odds ratios, and chi-square tests were used to evaluate the presence or absence of psychiatric disorders and NCDs in the presence or absence of sleep disorders. Adjusted odds ratios were calculated using the (Cochran-)Mantel-Haenszel test to adjust bias in gender (male and female) and age (under 65 and over 65).

Results
Based on Odds ratios and adjusted odds ratios, patients with sleep-wake disorders were found to be accompanied with bipolar disorder(F31), depression(F32), schizophrenia(F20), other anxiety disorders(F41), other neurological disorders(F48), delirium(F05), and Alzheimer's disease(G30). And patients with sleep-wake disorders were also found to be accompanied with ischemic heart disease(I209,I259,I219), diabetes mellitus(E11-E14), hypertension(I10), hyperlipidemia(E785,E780,E78), and hyperuricemia(E790). Concomitant use of psychotropic drugs other than sleeping pills and drugs related to NCDs such as diabetes mellitus and hypertension was also observed in patients with sleep disorders.

Discussion & Conclusion
To reduce mental illnesses and NCDs, it was suggested that the necessarity to impriving sleep disorders by optimizing drug prescriptions and improving lifestyle habits.