Causal associations of short and long sleep durations with 12 cardiovascular diseases: linear and nonlinear Mendelian randomization analyses in UK Biobank

2021 ◽  
Author(s):  
Sizhi Ai ◽  
Jihui Zhang ◽  
Guoan Zhao ◽  
Ningjian Wang ◽  
Guohua Li ◽  
...  
Keyword(s):  
Heart Disease ◽  
Arterial Hypertension ◽  
Ischaemic Heart Disease ◽  
Sleep Duration ◽  
Mendelian Randomization ◽  
Short Sleep Duration ◽  
Short Sleep ◽  
Causal Risk Factor ◽  
Long Sleep ◽  
Artery Disease

Abstract Aims Observational studies have suggested strong associations between sleep duration and many cardiovascular diseases (CVDs), but causal inferences have not been confirmed. We aimed to determine the causal associations between genetically predicted sleep duration and 12 CVDs using both linear and nonlinear Mendelian randomization (MR) designs. Methods and results Genetic variants associated with continuous, short (≤6 h) and long (≥9 h) sleep durations were used to examine the causal associations with 12 CVDs among 404 044 UK Biobank participants of White British ancestry. Linear MR analyses showed that genetically predicted sleep duration was negatively associated with arterial hypertension, atrial fibrillation, pulmonary embolism, and chronic ischaemic heart disease after correcting for multiple tests (P < 0.001). Nonlinear MR analyses demonstrated nonlinearity (L-shaped associations) between genetically predicted sleep duration and four CVDs, including arterial hypertension, chronic ischaemic heart disease, coronary artery disease, and myocardial infarction. Complementary analyses provided confirmative evidence of the adverse effects of genetically predicted short sleep duration on the risks of 5 out of the 12 CVDs, including arterial hypertension, pulmonary embolism, coronary artery disease, myocardial infarction, and chronic ischaemic heart disease (P < 0.001), and suggestive evidence for atrial fibrillation (P < 0.05). However, genetically predicted long sleep duration was not associated with any CVD. Conclusion This study suggests that genetically predicted short sleep duration is a potential causal risk factor of several CVDs, while genetically predicted long sleep duration is unlikely to be a causal risk factor for most CVDs.

scholarly journals Short or Long Sleep Duration and CKD: A Mendelian Randomization Study

2020 ◽  
Vol 31 (12) ◽  
pp. 2937-2947 ◽  
Author(s):  
Sehoon Park ◽  
Soojin Lee ◽  
Yaerim Kim ◽  
Yeonhee Lee ◽  
Min Woo Kang ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Kidney Function ◽  
Sleep Duration ◽  
Genetic Risk ◽  
Mendelian Randomization ◽  
Genetic Risk Score ◽  
Short Sleep Duration ◽  
Short Sleep ◽  
Long Duration ◽  
Long Sleep

BackgroundStudies have found sleeping behaviors, such as sleep duration, to be associated with kidney function and cardiovascular disease risk. However, whether short or long sleep duration is a causative factor for kidney function impairment has been rarely studied.MethodsWe studied data from participants aged 40–69 years in the UK Biobank prospective cohort, including 25,605 self-reporting short-duration sleep (<6 hours per 24 hours), 404,550 reporting intermediate-duration sleep (6–8 hours), and 35,659 reporting long-duration sleep (≥9 hours) in the clinical analysis. Using logistic regression analysis, we investigated the observational association between the sleep duration group and prevalent CKD stages 3–5, analyzed by logistic regression analysis. We performed Mendelian randomization (MR) analysis involving 321,260 White British individuals using genetic instruments (genetic variants linked with short- or long-duration sleep behavior as instrumental variables). We performed genetic risk score analysis as a one-sample MR and extended the finding with a two-sample MR analysis with CKD outcome information from the independent CKDGen Consortium genome-wide association study meta-analysis.ResultsShort or long sleep duration clinically associated with higher prevalence of CKD compared with intermediate duration. The genetic risk score for short (but not long) sleep was significantly related to CKD (per unit reflecting a two-fold increase in the odds of the phenotype; adjusted odds ratio, 1.80; 95% confidence interval, 1.25 to 2.60). Two-sample MR analysis demonstrated causal effects of short sleep duration on CKD by the inverse variance weighted method, supported by causal estimates from MR-Egger regression.ConclusionsThese findings support an adverse effect of a short sleep duration on kidney function. Clinicians may encourage patients to avoid short-duration sleeping behavior to reduce CKD risk.

scholarly journals Association of Sleep Duration With Atrial Fibrillation and Heart Failure: A Mendelian Randomization Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Jianqiang Zhao ◽  
Fangkun Yang ◽  
Chengui Zhuo ◽  
Qiyue Wang ◽  
Zihao Qu ◽  
...  
Keyword(s):  
Protective Effect ◽  
Sleep Duration ◽  
Mendelian Randomization ◽  
Inverse Association ◽  
Short Sleep Duration ◽  
Significant Evidence ◽  
Short Sleep ◽  
Long Sleep ◽  
Genetically Determined ◽  
Significant Protective Effect

Both short (&lt;7 h per night) and long (≥9 h per night) sleep durations are related to atrial fibrillation (AF) and heart failure (HF), but their causality has not been confirmed. We applied Mendelian randomization (MR) approaches to estimate the causal association between genetically determined sleep duration and the risk of AF and HF. We performed two-sample MR analysis to obtain the effect of sleep duration on AF and HF. Instrumental variables were constructed using genetic variants known to be associated with continuous sleep duration, short sleep duration, and long sleep duration. MR estimates of the effect of sleep duration on AF and HF were derived based on two large meta-analyses of genome-wide association studies. The pooled MR estimate demonstrated a significant protective effect of continuous sleep duration on HF [odds ratio (OR) = 0.765, 95% confidence interval (CI) = 0.675–0.867; P = 2.64 × 10–5] and a suggestive inverse association of continuous sleep duration with AF (OR = 0.893, 95% CI = 0.804–0.991; P = 0.034). In addition, the results showed a suggestive detrimental effect of short sleep duration on the risk of AF (OR = 1.108, 95% CI = 1.017–1.207; P = 0.019) and HF (OR = 1.136, 95% CI = 1.025–1.258; P = 0.015). Conversely, there is no significant evidence for the causal protective effect of long sleep duration on AF (OR = 0.956, P = 0.410) and HF (OR = 0.921, P = 0.202). This MR study indicated that genetically determined continuous sleep duration has a significant protective effect on HF and a suggestive inverse association with AF. Short sleep duration is positively associated with the risk of AF and HF. Nevertheless, there is no significant evidence for the causal protective effect of long sleep duration on AF and HF. Larger intervention studies are required to confirm the effectiveness of improving sleep on reducing the incidence of AF and HF.

scholarly journals CORONARY ARTERY DISEASES;

2017 ◽  
Vol 24 (10) ◽  
pp. 1471-1475
Author(s):  
Qari Hafiz Muhammad Habib Afzal ◽  
Kamran Ruaf ◽  
Areej Umber Khan ◽  
Asma Ashfaq ◽  
Muhammad Bilal Basit ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Sleep Duration ◽  
Case Series ◽  
Sleep Time ◽  
Coronary Artery Diseases ◽  
Short Sleep Duration ◽  
Short Sleep ◽  
Artery Disease

Introduction: Ischemic heart disease (IHD) is one of the leading causes ofdeath. Short sleep duration may increase the risk of coronary artery disease (CAD). The studywas designed to evaluate the association between CAD and sleep duration. Objectives: Todetermine the frequency of patients who have short sleep duration may suffer from CAD. Studydesign: Case series. Setting: Punjab Institute of Cardiology (PIC), Lahore. Period: It was carriedout in six months. Methods: 400 patients admitted who presented with IHD. Sleep durationwas categorized into three categories like <6 hours, 6-8 hours and >8 hours. Angiographywas performed for patients who have CAD. Results: Sleep duration was <6 hours, 6–8 hours,and >8 hours in 172 (43%), 124 (31%) and 104 (26%) patients respectively. Significant CADwas presented among 84 (21%) patients of sleep duration <6 hours, 16 (4%) patients of sleepduration 6–8 hours and 32 (8%) patients of >8 hours sleep duration. Conclusions: Significantnumber of patients has short sleep time and suffering from CAD.

scholarly journals Sleep Duration and Sleep Quality Are Associated with Physical Activity in Elderly People Living in Nursing Homes

2018 ◽  
Vol 15 (11) ◽  
pp. 2512 ◽  
Author(s):  
Lovro Štefan ◽  
Goran Vrgoč ◽  
Tomislav Rupčić ◽  
Goran Sporiš ◽  
Damir Sekulić
Keyword(s):  
Physical Activity ◽  
Nursing Homes ◽  
Sleep Quality ◽  
Sleep Duration ◽  
Short Sleep Duration ◽  
Cross Sectional ◽  
Elderly Individuals ◽  
Short Sleep ◽  
Long Sleep ◽  
Good Sleep

The main purpose of the study was to explore the associations of sleep duration and sleep quality with physical activity (PA). In this cross-sectional study, participants were 894 elderly individuals (mean age 80 ± 3 years; 56.0% women) living in nursing homes. PA, sleep duration, and sleep quality (based on the Pittsburgh Sleep Quality Index (PSQI)) were self-reported. The associations of sleep duration and sleep quality with PA at the nursing home level were analyzed using generalized estimating equations with clustering. Participants reporting short sleep duration (<6 h; OR = 0.45; 95% CI 0.25–0.80) were less likely to report sufficient PA, yet those reporting long sleep duration (>9 h; OR = 2.61; 95% CI 1.35–5.02) and good sleep quality (<5 points; OR = 1.59; 95% CI 1.19–2.12) were more likely to report sufficient PA. When sleep duration and sleep quality were entered into the same model, the same associations remained. This study shows that elderly individuals who report short sleep duration are less likely to meet PA guidelines, while those who report long sleep duration and good sleep quality are more likely to meet PA guidelines. Strategies aiming to improve sleep duration and sleep quality are warranted.

Abstract P108: Habitual Short Sleep Duration Associated with Self-Reported and Objectively-Determined Cardiovascular and Metabolic Disease Risk Factors: Data from NHANES

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Michael A Grandner ◽  
Subhajit Chakravorty ◽  
Michael Perlis ◽  
Linden Oliver ◽  
Indira Gurubhagavatula
Keyword(s):  
Food Security ◽  
Sleep Duration ◽  
Home Ownership ◽  
Elevated Risk ◽  
Outcome Variable ◽  
Cardiometabolic Health ◽  
Short Sleep Duration ◽  
Short Sleep ◽  
Long Sleep ◽  
Race Ethnicity

Background: Self-reported short and long sleep duration have been associated with adverse cardiometabolic health outcomes in laboratory and epidemiologic studies, but interpretation of such data has been limited by methodological issues. Methods: We analyzed adult 2007-2008 US National Health and Nutrition Examination Survey (NHANES) data (N=5,649). Average self-reported nightly sleep duration was reported and categorized as either very short (<5h), short (5-6h), normal (7-8h), or long (≥9h). Self-reported as well as objective evidence of obesity, diabetes, hypertension, and hyperlipidemia were recorded. Univariate comparisons were conducted across sleep duration categories for all variables. Binary logistic regression analyses were performed using cardiometabolic factor as the outcome variable, and sleep duration category as the predictor variable, before and after adjusting for age, sex, race/ethnicity, acculturation, education, access to insurance, food security, home ownership, smoking, and caffeine use. Results: See table. In adjusted analyses, very short sleep was associated with self-reported hypertension, self-reported hyperlipidemia, objective hyperlipidemia, self-reported diabetes, and objective obesity. Regarding short sleep (5-6hrs), in adjusted analyses, elevated risk was seen for self-reported hypertension self-reported obesity and objective obesity. Regarding long sleep (≥9hrs), no elevated risk was found for any outcomes. Conclusions: Very short and short sleep duration are associated with self-reported and objectively-determined adverse cardiometabolic outcomes, even after adjustment for covariates. Table 1. Unadjusted and Adjusted Odds Ratios (OR) and 95% Confidence Intervals (95%CI) of Associations between Sleep Duration and Cardiometabolic Disease Outcomes *Adjusted analyses include age, sex, race/ethnicity, acculturation, education, insurance, home ownership, food security, smoking, and caffeine

scholarly journals 879Sleep Duration and all-cause and cause-specific mortality in people with diabetes

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Yohannes Adama Melaku ◽  
Sarah Appleton ◽  
Amy Reynolds ◽  
Tiffany Gills ◽  
Robert Adams
Keyword(s):  
Sensitivity Analysis ◽  
Sleep Duration ◽  
Dose Response ◽  
Mortality Risk ◽  
The United States ◽  
Diabetic Patients ◽  
Short Sleep Duration ◽  
Short Sleep ◽  
Long Sleep ◽  
Specific Mortality

Abstract Background Evidence shows that habitual short and long sleep is associated with higher mortality risk in the general population. However, studies on the association between sleep duration and mortality in people with diabetes are scarce. Methods Data from the National Health Interview Survey (NHIS) of the United States (US) between 2004 and 2014 (N = 32,766) were used. Self-reported habitual sleep duration for those with self-reported doctor diagnosed diabetes was categorized as ≤ 6 hr (short sleep), 7-8 hr (adequate sleep), and ≥9 hr (long sleep). Mortality status and cause of death data were retrieved from the US National Death Index and linked. We used adjusted Cox proportional models to examine the association between sleep duration and mortality risk. Dose-response relationships were quantified. Sensitivity analysis was performed excluding cardiovascular and cancer cases. Results In the median follow-up time of 4.6 years (171,375.2 person-years), 5312 all-cause, 1129 cardiovascular, 1148 cancer and 494 diabetes deaths were recorded. Whereas short sleep duration (adjusted hazard ratio (aHR)=1.04; 95% confidence interval (CI): 0.97, 1.11) in diabetic patients was not associated with all-cause mortality, long sleep duration was positively (aHR=1.43; 95% CI: 1.30, 1.57) associated with increased mortality risk. A similar trend of association was found with cause-specific mortality and the dose-response analysis identified a “J” shape association. Similar results were found upon sensitivity analysis. Conclusions Long but not short sleep duration is associated with all-cause and cause-specific mortality in diabetic patients. Key messages Sleep should be part of behavioural intervention to prevent premature mortality in those with diabetics.

scholarly journals Bidirectional Associations between Short or Long Sleep Duration and Cognitive Function: the China Health and Retirement Longitudinal Study

2021 ◽  
Author(s):  
Jianian Hua ◽  
Hongpeng Sun ◽  
Qi Fang
Keyword(s):  
Longitudinal Study ◽  
Cognitive Function ◽  
Sleep Duration ◽  
Short Sleep Duration ◽  
Short Sleep ◽  
Bidirectional Association ◽  
Long Sleep ◽  
Global Cognition ◽  
Bidirectional Associations ◽  
Prospective Longitudinal

AbstractIMPORTANCEThe bidirectional association between sleep duration and cognitive function has not been conclusively demonstrated.OBJECTIVETo investigate the longitudinal association between sleep duration and cognitive function among middle-aged and elderly Chinese participants.Design, SETTING, AND PARTICIPANTSA national representative and prospective longitudinal study in China. 7984 participants aged 45 years and above were assessed at baseline between June 2011 and March 2012 (wave 1) and 2013 (wave 2), 2015 (wave 3) and 2018 (wave4).MAIN OUCOMES AND MEASURESSelf-reported nighttime sleep duration was evaluated by interview. Cognitive function was evaluated via assessments of global cognition, which reflected the ability of episodic memory, visuospatial construction, calculation, orientation and attention.ResultsRegarding the 7984 participants in wave 4, the mean (SD) age was 64.7 (8.4), 3862 (48.4) were male, and 6453 (80.7) lived in rural area. There were 14981, 11768 (78.6%), 10192 (68.0%), 7984 (53.3%) participants in the four waves of the study, respectively. Latent growth models showed both sleep duration and global cognition worsen over time. Cross-lagged models indicated that long or short sleep duration in the previous wave was associated lower global cognition in the next wave (standardized β=-0.066; 95%CI: −0.073, −0.059; P<0.001; Wave 1 to 2), and lower global cognition in the previous wave was associated with long or short sleep duration in the next wave (standardized β=-0.106; 95%CI: −0.116, −0.096; P<0.001; Wave 1 to 2). Global cognition was probably the major driver in this reciprocal associations.CONCLUSIONS AND REVELANCEThere were bidirectional associations between long or short sleep duration and cognitive function. Lower cognitive function had a stronger association with worse cognitive function than the reverse. A moderate sleep duration is always recommended. Moreover, attention should be paid on the declined cognition and cognitive therapy among older adults with short or long sleep duration.

scholarly journals Sleep Duration and Stroke

Stroke ◽  
2020 ◽  
Vol 51 (11) ◽  
pp. 3279-3285
Author(s):  
Olga E. Titova ◽  
Karl Michaëlsson ◽  
Susanna C. Larsson
Keyword(s):  
Ischemic Stroke ◽  
Intracerebral Hemorrhage ◽  
Prospective Study ◽  
Sleep Duration ◽  
Mendelian Randomization ◽  
Short Sleep ◽  
Mendelian Randomization Analysis ◽  
Increased Risk ◽  
Long Sleep ◽  
Randomization Analysis

Background and Purpose: Studies of sleep duration in relation to specific types of stroke are scarce. Moreover, the results are inconclusive and causality remains unclear. Our objective was to investigate whether sleep duration is associated with risk of stroke and its types using observational and Mendelian randomization designs. Methods: The prospective study included 79 881 women and men (45–79 years of age) who were followed up for incident stroke or death over a mean follow-up of 14.6 years (1 164 646 person-years) through linkage to Swedish Registers. For the Mendelian randomization study, single-nucleotide polymorphisms associated with sleep duration were identified from a genome-wide association study. Summarized data for genetic associations with stroke were obtained from publicly available data of the MEGASTROKE and the International Stroke Genetics Consortia. Results: Compared with normal sleep duration, long sleep (≥9 hours per day) was associated with increased risk of total and ischemic stroke (hazard ratios [95% CI], 1.12 [1.03–1.22] and 1.14 [1.03–1.24], respectively), whereas short sleep (<7 h/d) was linked to higher risk of intracerebral hemorrhage (hazard ratio [95% CI], 1.21 [1.03–1.41]). The 2-sample Mendelian randomization analysis supported no causal association of short or long sleep duration with ischemic stroke as a whole. Conclusions: In a prospective study, long sleep duration was associated with increased risk of total and ischemic stroke, whereas short sleep was linked to increased risk of intracerebral hemorrhage. However, the Mendelian randomization analysis did not show a significant detrimental effect of short or long sleep duration on the risk of total stroke or stroke types.

Abstract MP073: Sleep Patterns and Depression in a Diverse Sample of Women from the AHA Go Red for Women Strategically Focused Research Network (SFRN)

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Brooke Aggarwal ◽  
Ming Liao
Keyword(s):  
Depressive Symptoms ◽  
Sleep Quality ◽  
Sleep Duration ◽  
Minority Women ◽  
Poor Sleep ◽  
Sleep Patterns ◽  
Short Sleep Duration ◽  
Short Sleep ◽  
Long Sleep ◽  
Race Ethnicity

Background: Depression has been linked to increased risk of cardiovascular disease (CVD) through biological mechanisms and altered lifestyle behaviors, possibly including short and/or long sleep duration. However the relation between specific sleep components and depressive symptoms, and interaction by race/ethnicity has not been fully defined. The purpose of this study was to determine if sleep patterns including short sleep duration, poor sleep quality, and insomnia were associated with depressive symptoms in a free-living ethnically diverse population of adult women, and if they varied by racial/ethnic status. Methods: English or Spanish speaking females between the ages of 20-79 y, participating in an observational cohort study as part of the American Heart Association Go Red for Women SFRN, were included (n=50, 56% (28 of 50) non-white, mean age = 41 ±18y). Sleep patterns were assessed using the Pittsburgh Sleep Quality Index (PSQI), a validated instrument used to measure the quality and duration of sleep in adults. Presence of insomnia was measured using the Insomnia Severity Index (ISI). Depressive symptoms were assessed using the Beck Depression Inventory (BDI-II). Linear and logistic regression models were used to evaluate cross-sectional associations between sleep patterns and depression overall, and by race/ethnicity. Results: Overall, nearly one-fifth of participants had depressive symptoms (BDI II score ≤13), 18% (9 of 50) had short sleep duration (<6 hours per night), 38% (19 of 50) had poor quality sleep (PSQI score ≥5), and 40% (20 of 50) had some level of insomnia (ISI score ≥8). Mean BDI-II scores among women who slept <6 versus ≥6 hours were significantly greater (16 versus 5, p=.0003). Higher depression scores were associated with shorter sleep duration (p=.001), poorer sleep quality (p=.03), and higher insomnia severity (p<.0001) overall. There was no association between depression and long sleep (≥8 hours). When stratified by race/ethnicity, depression was significantly associated with poor sleep quality among minority women in multivariable models adjusted for demographic confounders (OR=1.42, 95% CI=1.03-1.95), but not among non-Hispanic white women. Depression was also significantly associated with insomnia severity (p<.001), and sleep duration (p=.03) among minority women only, in multivariable adjusted models stratified by race/ethnicity. Conclusions: In this diverse sample of women, sleep problems were highly prevalent. Poor sleep quality, insomnia, and short sleep duration (but not long sleep) were associated with greater depressive symptoms among minority women but not whites. These preliminary data suggest that minority women with short sleep duration may be at heightened CVD risk from depression. Future research should determine if interventions designed to improve sleep result in decreased depressive symptoms and reduced CVD risk.

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