Objective short sleep duration modifies the relationship between hypertension and all-cause mortality

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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0313 INSOMNIA WITH OBJECTIVE SHORT SLEEP DURATION AND ALL-CAUSE MORTALITY: SLEEP HEART HEALTH STUDY

SLEEP ◽

10.1093/sleepj/zsx050.312 ◽

2017 ◽

Vol 40 (suppl_1) ◽

pp. A116-A116

Author(s):

S Bertisch ◽

B Pollock ◽

MA Mittleman ◽

LA Bazzano ◽

DJ Buysse ◽

...

Keyword(s):

Sleep Duration ◽

Health Study ◽

Heart Health ◽

Short Sleep Duration ◽

Short Sleep ◽

All Cause Mortality

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Association between self-reported sleep duration and dietary quality in European adolescents

British Journal Of Nutrition ◽

10.1017/s0007114512006046 ◽

2013 ◽

Vol 110 (5) ◽

pp. 949-959 ◽

Cited By ~ 40

Author(s):

Sarah Bel ◽

Nathalie Michels ◽

Tineke De Vriendt ◽

Emma Patterson ◽

Magdalena Cuenca-García ◽

...

Keyword(s):

Sleep Duration ◽

Healthy Lifestyle ◽

Dietary Diversity ◽

Dietary Quality ◽

Short Sleep Duration ◽

Cross Sectional ◽

Insufficient Sleep ◽

Short Sleep ◽

Relationship Of ◽

The Relationship

Evidence has grown supporting the role for short sleep duration as an independent risk factor for weight gain and obesity. The purpose of the present study was to examine the relationship between sleep duration and dietary quality in European adolescents. The sample consisted of 1522 adolescents (aged 12·5–17·5 years) participating in the European multi-centre cross-sectional ‘Healthy Lifestyle in Europe by Nutrition in Adolescence’ study. Sleep duration was estimated by a self-reported questionnaire. Dietary intake was assessed by two 24 h recalls. The Diet Quality Index for Adolescents with Meal index (DQI-AM) was used to calculate overall dietary quality, considering the components dietary equilibrium, dietary diversity, dietary quality and a meal index. An average sleep duration of ≥ 9 h was classified as optimal, between 8 and 9 h as borderline insufficient and < 8 h as insufficient. Sleep duration and the DQI-AM score were positively associated (β = 0·027, r 0·130, P< 0·001). Adolescents with insufficient (62·05 (sd 14·18)) and borderline insufficient sleep (64·25 (sd 12·87)) scored lower on the DQI-AM than adolescents with an optimal sleep duration (64·57 (sd 12·39)) (P< 0·001; P= 0·018). The present study demonstrated in European adolescents that short sleep duration was associated with a lower dietary quality. This supports the hypothesis that the health consequences of insufficient sleep may be mediated by the relationship of insufficient sleep to poor dietary quality.

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Modeling Sleep and Adiposity-Associated Cardiometabolic Disease Risk Factors: Protocol for the SLUMBRx Study (Preprint)

10.2196/preprints.27139 ◽

2021 ◽

Author(s):

Adam Knowlden ◽

John Higginbotham ◽

Michael Grandner ◽

John Allegrante

Keyword(s):

Risk Factors ◽

Sleep Duration ◽

Disease Risk ◽

Cardiometabolic Disease ◽

Health Issues ◽

Short Sleep Duration ◽

Short Sleep ◽

Adiposity Indices ◽

The Relationship ◽

Cardiometabolic Disease Risk

BACKGROUND Obesity and short sleep duration are significant public health issues. Current evidence suggests these conditions are associated with cardiovascular disease, metabolic syndrome, inflammation, and premature mortality. Increased interest in the potential link between obesity and short sleep duration, and its health consequences, has been driven by: 1) the apparent parallel increase in prevalence of both conditions in recent decades; 2) their overlapping association with cardiometabolic outcomes; and 3) the potential causal connection between the two health issues. The Short Sleep Undermines Cardiometabolic Health (SLUMBRx) Study seeks to contribute to the development of a comprehensive adiposity-sleep model, while laying the groundwork for a future program of research that will be designed to prevent and treat adiposity and sleep-related cardiometabolic disease risk factors. OBJECTIVE SLUMBRx addresses four topics pertinent to the adiposity-sleep hypothesis: 1) the relationship between adiposity and sleep duration; 2) sex-based differences in the relationship between adiposity and sleep duration; 3) influence of adiposity indices and sleep duration on cardiometabolic outcomes; and 4) the role of socioecological factors as effect modifiers in the relationship between adiposity indices, sleep, and cardiometabolic outcomes. METHODS SLUMBRx will employ a large-scale survey (n=1,000) that recruits 159 participants (53 normal weight, 53 overweight, and 53 obese) to be assessed in two phases. RESULTS Phase 1, a lab-based study, will gather objective adiposity indices (air displacement plethysmography and anthropometrics) and cardiometabolic data (blood pressure, pulse wave velocity and pulse wave analysis, and blood-based biomarker). Phase 2, a one-week, home-based study, will gather sleep-related data (home sleep testing/sleep apnea, actigraphy, sleep diaries). During Phase 2, detailed demographic and socioecological data will be collected to contextualize hypothesized adiposity and sleep-associated cardiometabolic disease risk factors. Collection and analyses of these data will yield information necessary to customize future observational and intervention research. CONCLUSIONS Precise implementation of the SLUMBRx protocol promises to provide objective, empirical data on the interaction between body composition and sleep duration. The hypotheses that will be tested by SLUMBRx are important for understanding the pathogenesis of cardiometabolic disease and for developing future public health interventions to prevent its conception and treat its consequences. CLINICALTRIAL https://projectreporter.nih.gov/project_info_description.cfm?aid=9822114&icde=45818775

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The relationship between insomnia with short sleep duration is associated with hypercholesterolemia: a cross-sectional study

Journal of Advanced Nursing ◽

10.1111/jan.12844 ◽

2015 ◽

Vol 72 (2) ◽

pp. 339-347 ◽

Cited By ~ 6

Author(s):

Chia-Ling Lin ◽

Yu-Hsia Tsai ◽

Mei Chang Yeh

Keyword(s):

Sleep Duration ◽

Cross Sectional Study ◽

Sectional Study ◽

Short Sleep Duration ◽

Cross Sectional ◽

Short Sleep ◽

The Relationship

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

SLEEP ◽

10.1093/sleep/zsy047 ◽

2018 ◽

Vol 41 (6) ◽

Cited By ~ 53

Author(s):

Suzanne M Bertisch ◽

Benjamin D Pollock ◽

Murray A Mittleman ◽

Daniel J Buysse ◽

Lydia A Bazzano ◽

...

Keyword(s):

Cardiovascular Disease ◽

Sleep Duration ◽

Health Study ◽

Heart Health ◽

Short Sleep Duration ◽

Short Sleep ◽

All Cause Mortality ◽

Incident Cardiovascular Disease

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Objective short sleep duration increases the risk of all-cause mortality associated with possible vascular cognitive impairment

Sleep Health ◽

10.1016/j.sleh.2019.09.003 ◽

2020 ◽

Vol 6 (1) ◽

pp. 71-78 ◽

Cited By ~ 2

Author(s):

Julio Fernandez-Mendoza ◽

Fan He ◽

Susan L. Calhoun ◽

Alexandros N. Vgontzas ◽

Duanping Liao ◽

...

Keyword(s):

Cognitive Impairment ◽

Sleep Duration ◽

Vascular Cognitive Impairment ◽

Short Sleep Duration ◽

Short Sleep ◽

All Cause Mortality

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The relationship between sleep duration and all-cause mortality in the older people: an updated and dose-response meta-analysis

10.21203/rs.2.22427/v2 ◽

2020 ◽

Author(s):

Mengyang He ◽

Xiangling Deng ◽

Yuqing Zhu ◽

Luyao Huan ◽

Wenquan Niu

Keyword(s):

Older People ◽

Sleep Duration ◽

Dose Response ◽

Data Extraction ◽

Meta Analysis ◽

Short Sleep Duration ◽

Short Sleep ◽

Increased Risk ◽

Long Sleep ◽

All Cause Mortality

Abstract Background: Short or long sleep duration is proposed as a potential risk factor for all-cause mortality in the older people, yet the results of published studies are not often reproducible. Objectives: We aimed to investigate whether short or long sleep duration was associated with an increased risk of all-cause mortality in the older people via a comprehensive meta-analysis. Methods: Literature retrieval, study selection and data extraction were completed independently and in duplicate. Effect-size estimates are expressed as relative risk (RR) and its 95% confidence interval (CI). Results: Summary data from 35 articles, involving a total of 106990 older people, were meta-analyzed. Overall analyses revealed a significant association between long sleep duration and all-cause mortality (RR=1.27, 95% CI: 1.19-1.35, P <.001), whereas marginal significance was observed for short sleep duration (RR=1.05; 95% CI: 1.00-1.09; P =.045). There was a low probability of publication bias as indicated by Egger’s test for the association between sleep duration and all-cause mortality. In subgroup analyses, the association between long sleep duration and all-cause mortality was relatively strong in women (RR=1.48, 95% CI: 1.18-1.85, P =.002) relative to men (RR=1.30, 95% CI: 1.10-1.50, P =.001) (Two-sample Z test P = .219). Further dose-response regression analyses showed that trend estimation was not obvious for short sleep duration ( P = .016) compared with long sleep duration ( P < .001), indicating a J-shaped relationship between sleep duration and all-cause mortality. Conclusions: Our findings indicate a J-shaped relationship between sleep duration and all-cause mortality in the older people, with long sleep duration significantly associating with all-cause mortality, especially in women.

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Associations of impaired glucose tolerance and sleep disorders with mortality among the US general population

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-002047 ◽

2021 ◽

Vol 9 (1) ◽

pp. e002047

Author(s):

Kosuke Inoue ◽

Eriko Semba ◽

Tadashi Yamakawa ◽

Yasuo Terauchi

Keyword(s):

General Population ◽

Glucose Tolerance ◽

Impaired Glucose Tolerance ◽

Sleep Disorders ◽

Sleep Duration ◽

Short Sleep Duration ◽

Short Sleep ◽

The Us ◽

All Cause Mortality ◽

Glucose Tolerance Status

IntroductionSleep disorders and short sleep duration are common symptoms among people with diabetes. However, the evidence is limited about the associations of post-challenge hyperglycemia and sleep quality or quantity with all-cause mortality in the US general population.Research design and methodsOur study included 8795 adults from the National Health and Nutrition Examination Survey 2005–2014. Mortality data were ascertained through 2015. Multivariable Cox proportional-hazards models were used to estimate adjusted HRs (aHRs) for all-cause mortality according to 2-hour plasma glucose levels during the 75 g oral glucose tolerance test—normal glucose tolerance (NGT), <140 mg/dL; impaired glucose tolerance (IGT), 140–199 mg/dL; and diabetes, ≥200 mg/dL. We then examined the associations of glucose tolerance status and self-reported physician-diagnosed sleep disorders (yes vs no) or sleep duration (<7 vs ≥7 hours) with all-cause mortality.ResultsDuring follow-up (median, 5.6 years), the diabetes group had a higher risk of all-cause mortality compared with the NGT group (aHR (95% CI)=1.93 (1.41 to 2.64)), but not the IGT group (aHR (95% CI)=1.19 (0.90 to 1.59)). When we categorized participants according to glucose tolerance status and sleep disorders, the IGT group with sleep disorders had a higher risk of all-cause mortality (aHR (95% CI)=2.03 (1.24 to 3.34)) compared with the NGT group without sleep disorders. Both diabetes groups with and without sleep disorders also showed high mortality risks. The results were consistent when we used sleep duration instead of sleep disorders.ConclusionsUsing the most updated US national data, we found a high risk of all-cause mortality among individuals with IGT having sleep disorders or short sleep duration as well as those with diabetes. Future investigations are needed to identify whether and what kind of sleep management is beneficial for people with impaired glucose metabolism to prevent early death.

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