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Extreme sleep duration, poor sleep quality may increase prevalence of subclinical arterial disease
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Healthy men and women who reported too much or too little sleep and poor sleep quality were more likely to have coronary artery calcification and higher brachial-ankle pulse wave velocity, indicative of subclinical vascular disease, researchers reported.
In a cross-sectional study, researchers evaluated data on asymptomatic adults collected during a health checkup. Sleep duration and quality were assessed via questionnaire, and patients underwent measurement of coronary artery calcification (CAC; n = 29,203) for the detection of early coronary lesions or brachial-ankle pulse wave velocity (n = 18,106) to assess arterial stiffness.
The researchers observed a U-shaped association between CAC and duration of sleep. A positive CAC score was reported in 16.2% of patients with 5 hours or less of sleep per night, 15.1% of those with 6 hours of sleep, 12.5% of those with 7 hours of sleep, 12.6% of those with 8 hours of sleep and 18.4% of those with 9 hours or more of sleep. Compared with 7 hours of sleep per night, CAC score ratios were 1.5 (95% CI, 1.17-1.93) for 5 hours or less, 1.34 (95% CI, 1.1-1.63) for 6 hours, 1.37 (95% CI, 0.99-1.89) for 8 hours and 1.72 (95% CI, 0.9-3.28) for 9 hours or more (P = .002 for quadratic trend), according to multivariate analysis.
A similar U-shaped association was observed between brachial-ankle pulse wave velocity and sleep duration. Compared with 7 hours of sleep per night, the researchers calculated average differences in brachial-ankle pulse wave velocity of 6.7 cm/s (95% CI, 0.75-12.6) for 5 hours or less of sleep per night, 2.9 cm/s (95% CI, –1.7 to 7.4) for 6 hours, 10.5 cm/s (95% CI, 4.5-16.5) for 8 hours and 9.6 cm/s (95% CI, –0.7 to 19.8) for 9 hours or more (P = .019 for quadratic trend).
A positive CAC score was more common among women who reported poor subjective sleep quality compared with those who reported good-quality sleep (8.8% vs. 5.6%; P < .001). Adjustment for confounders and mediators did not significantly alter this association.
The link between sleep quality and positive CAC score was not present among men (16.9% for poor-quality sleep vs. 15.8% for good-quality sleep; P = .13).
However, the researchers observed a significant association between poor sleep quality and increased brachial-ankle pulse wave velocity among men, but not women.
“Overall, we saw the lowest levels of vascular disease in adults sleeping 7 hours a day and reporting good sleep quality,” Chan-Won Kim, MD, clinical associate professor at the Center for Cohort Studies at Kangbuk Samsun Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea, said in a press release. “For doctors, it might be necessary to assess patients’ sleep quality when they evaluate CV risk and the health status of men and women.” – by Adam Taliercio
Disclosure: The researchers report no relevant financial disclosures.
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