The Prognostic Nutritional Index as a Lifeline for Cardiovascular Health in Individuals With Insomnia: A Prospective Cohort Study.

Background and Aims: This study aimed to examine the relationship between the prognostic nutritional index (PNI) and both all-cause and cardiovascular mortality among individuals diagnosed with insomnia. Methods: A total of 3161 participants from the NHANES database were analyzed, stratified by the severity of insomnia (mild, moderate, severe). Weighted Cox regression models were employed to evaluate the associations between PNI and mortality, while subgroup and interaction analyses were conducted to assess consistency across various demographic groups. Kaplan-Meier survival curves were utilized to compare survival rates across PNI quartiles, and Receiver Operating Characteristic (ROC) curves were used to evaluate the predictive accuracy of PNI. Additionally, Restricted Cubic Spline (RCS) analysis was performed to identify safety thresholds for PNI. Results: Among the participants, 16% were classified as having severe insomnia. A higher PNI, within a specific range, was found to be protective against cardiovascular mortality (Hazard Ratio [HR] = 0.24, 95% Confidence Interval [CI]: 0.14-0.41, Conclusion: An elevated PNI, within a defined range, is associated with reduced mortality risks in patients with insomnia, whereas PNI levels below 53.35 for all-cause mortality and 51.9 for cardiovascular mortality are associated with heightened risk. PNI may serve as a valuable prognostic tool in this population. Clinical Trial Registration: NA.