Insomnia with objective short sleep duration and risk of incident cardiovascular disease and all-cause mortality: Sleep Heart Health Study

ObjectivesWe analysed association between short sleep duration and prevalence of cardiovascular disease (CVD) in a multiethnic population living in the Netherlands, and the contribution of short sleep to the observed ethnic differences in the prevalence of CVD, independent of CVD risk factors.Methods20 730 participants (aged 18–71 years) of the HELIUS (Healthy Life in an Urban Setting) Study were investigated. Self-reported sleep duration was classified as: short (<7 hours/night) and healthy (7–9 hours/night). Prevalence of CVD was assessed using the Rose Questionnaire on angina pectoris, intermittent claudication and possible myocardial infarction. Association of short sleep duration with prevalent CVD and the contribution of short sleep to the observed ethnic differences in the prevalence of CVD were analysed using adjusted prevalence ratio(s) (PRs) with 95% CI.ResultsResults indicate that short sleep was associated with CVD among all ethnic groups with PRs ranging from 1.41 (95% CI 1.21 to 1.65) in Moroccans to 1.62 (95% CI 1.20 to 2.18) in Dutch after adjustment for age, sex and conventional CVD risk factors. The independent contributions of short sleep (in percentage) to ethnic differences in CVD compared with Dutch were 10%, 15%, 15%, 5% and 5% in South-Asian Surinamese, African-Surinamese, Ghanaian, Turkish and Moroccan, respectively.ConclusionShort sleep contributed to ethnic differences in CVD independent of well-known CVD risk factors particularly in Surinamese and Ghanaian groups. Reducing sleep deprivation may be a relevant entry point for reducing increased CVD risks among the various ethnic minority groups.

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Abstract MP94: Short Sleep Duration Modifies the Relationship Between Cognitive Impairment Associated with Cardiovascular Disease and All-cause Mortality

Circulation ◽

10.1161/circ.133.suppl_1.mp94 ◽

2016 ◽

Vol 133 (suppl_1) ◽

Author(s):

Julio Fernandez-Mendoza ◽

Fan He ◽

Alexandros N Vgontzas ◽

Duanping Liao ◽

Edward O Bixler

Keyword(s):

Cognitive Impairment ◽

Sleep Duration ◽

Population Sample ◽

Vascular Cognitive Impairment ◽

Short Sleep Duration ◽

Short Sleep ◽

Increased Risk ◽

All Cause Mortality ◽

Penn State ◽

The Relationship

Introduction: Short sleep duration has been associated with increased risk of cardiovascular and cerebrovascular disease (CVD), cognitive impairment (CI) and mortality. However, the role of sleep duration in predicting mortality in the context of CVD and CI is still not well-understood. Hypothesis: Short sleep duration is a key effect modifier of the relationship between CI associated with CVD and all-cause mortality. Methods: We addressed this hypothesis in the Penn State Adult Cohort, a random, general population sample of 1,741 middle-aged adults who were studied in the sleep lab and followed-up for 15y. An in-lab, 8-hour polysomnography was performed to ascertain sleep duration. CI associated with CVD was defined by the presence of hypertension, diabetes, heart disease and/or stroke with impaired higher-order, executive cognitive functioning, including slow processing speed. We tested the interaction between sleep duration and CI associated with CVD on all-cause mortality with multiple logistic regression while adjusting for sex, age, race, obesity, smoking, cholesterol, depression, insomnia, dementia, and sleep apnea. Results: The odds of mortality associated with CI-alone, CVD-alone, and CI associated with CVD were 1.3 (95% CI: 0.7-2.4), 1.7 (95% CI: 1.1-2.8), and 4.6 (95% CI: 2.8-7.7), respectively. As shown in Figure 1, the interaction between CI associated with CVD and sleep duration was significant (p < .01), indicating that the probability of mortality increased significantly as a function of shorter sleep duration in individuals with CI associated with CVD. Conclusion: We found that objective sleep duration modifies the relationship between CI associated with CVD and all-cause mortality in a dose-response manner. Short sleep duration in individuals with probable vascular cognitive impairment (VCI) may serve as a biomarker of the severity of central autonomic dysfunction. Future studies should examine whether improving sleep reduces the odds of mortality in individuals with VCI.

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1015 IMPACT OF SHORT SLEEP DURATION ON MORTALITY RISK ASSOCIATED WITH CARDIOVASCULAR DISEASE AND STROKE

SLEEP ◽

10.1093/sleepj/zsx050.1014 ◽

2017 ◽

Vol 40 (suppl_1) ◽

pp. A378-A378

Author(s):

J Fernandez-Mendoza ◽

F He ◽

AN Vgontzas ◽

D Liao ◽

EO Bixler

Keyword(s):

Cardiovascular Disease ◽

Sleep Duration ◽

Mortality Risk ◽

Short Sleep Duration ◽

Short Sleep

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Short Sleep Duration Insomnia May Be Associated With Increased Cardiovascular Disease in Schizophrenics

CHEST Journal ◽

10.1378/chest.1703315 ◽

2013 ◽

Vol 144 (4) ◽

pp. 996A

Author(s):

Terese Hammond ◽

Joleen Aguon ◽

Janet Sobell ◽

Brooke Sklar ◽

Michele Pato

Keyword(s):

Cardiovascular Disease ◽

Sleep Duration ◽

Short Sleep Duration ◽

Short Sleep

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Abstract P072: Short Sleep Duration is Associated with Elevated Homocysteine Levels

Circulation ◽

10.1161/circ.131.suppl_1.p072 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Megan E Petrov ◽

Michael A Grandner ◽

Carol M Baldwin ◽

Matthew P Buman ◽

Shawn D Youngstedt

Keyword(s):

Cardiovascular Disease ◽

Sleep Duration ◽

Multinomial Logistic Regression ◽

Menopausal Status ◽

Short Sleep Duration ◽

Dietary Folate ◽

Short Sleep ◽

Long Sleep ◽

History Of ◽

The Relationship

Introduction: Short and long sleep durations are associated with heightened risk for cardiovascular disease and vascular risk factors. Elevated homocysteine is also associated with greater risk for cardiovascular disease; however, studies have yet to investigate the relationship between sleep duration and homocysteine. Hypothesis: We hypothesized that short and long sleep duration would be associated with clinical levels of homocysteine. Methods: Adults (n=2,469; ≥20y) from the 2005-2006 National Health and Nutrition Examination Survey (NHANES) were assessed for habitual sleep duration (coded as <5, 5, 6, 7, 8, 9, and ≥10hrs) and fasting plasma homocysteine levels (<10 [normative], 10 to <15 [pre-clinical] and ≥15 [clinical] μmol/L). Participants were excluded if pregnant, lactating, missing data on the primary variables, or if they had a history of cardiovascular disease, cancer, diabetes, kidney disease, or diagnosed sleep disorder. Population weighted, multinomial logistic regression analyses assessed the relationship between sleep duration and homocysteine after adjustment for age, sex, race/ethnicity, marital and menopausal status, shift work, dietary folate, alcohol intake, cotinine levels, reported physical activity, hypertension, and reported frequency of cessation of breathing at night. Results: Pre-clinical and clinical levels of homocysteine were present in 13.7% and 2.5% of the sample, respectively. The mean sleep duration was 6.9 ± 1.4 hours. In adjusted analyses, sleep duration was significantly related to homocysteine ( p < 0.001). See Table. Very short sleepers (<5hrs) were more likely to have clinical levels of homocysteine (OR: 3.01, 95%CI: 1.38, 6.57) compared to 7-hr sleepers. Conclusions: In a U.S. representative sample of adults without cardiovascular disease or other major conditions, short sleepers were at greater odds for clinical levels of homocysteine Findings suggest that homocysteine may be one mechanism linking short sleep duration to cardiovascular disease.

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