Issue: November 2019

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October 02, 2019
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Sleep duration may be predictive of cardiometabolic risk factors, cerebrovascular disease mortality

Issue: November 2019
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Julio Fernandez-Mendoza

Sleep duration was found to be a significant predictor of cardiometabolic risk factors and cerebrovascular disease mortality as well as cancer mortality.

According to a study published in the Journal of the American Heart Association, researchers observed an increased risk for all-cause mortality associated with cardiometabolic risk factors (HR = 2.14; 95% CI, 1.52-3.02) and all-cause mortality associated with cerebrovascular disease (HR = 3.17; 95% CI, 2.16-4.65) in adults who slept less than 6 hours per night.

Moreover, in adults with lower overall sleep time, cardiometabolic risk factors led to a 1.83 times higher risk for cerebrovascular disease mortality (95% CI, 1.07-3.13) and cerebrovascular disease led to a 2.92 times higher risk for cancer mortality (95% CI, 1.28-6.65).

“Many patients in cardiology and other outpatient clinics undergo a sleep study to rule out sleep apnea,” Julio Fernandez-Mendoza, PhD, associate professor at Pennsylvania State College of Medicine and sleep psychologist at the Sleep Research and Treatment Center of the Penn State Health Milton S. Hershey Medical Center in Hershey, Pennsylvania, told Healio. “Our data indicate that, beyond sleep apnea, sleep studies can also help us identify those patients with hypertension or diabetes or those with a history of heart disease or stroke with worse prognosis, as indicated by their short sleep duration and increased risk of mortality.”

In other findings, researchers observed that cardiometabolic risk factors were not significantly related to cerebrovascular disease mortality (HR = 1.35; 95% CI, 0.7-2.63) in adults who slept 6 hours or more. In addition, cerebrovascular disease was also not associated with cancer mortality in these adults.

“Patients with cardiovascular risk factors or diseases should be routinely evaluated for their sleep complaints and undergo a sleep study,” Fernandez-Mendoza said in an interview. “The data indicate that treatment should be multifactorial to address the cardiovascular disorder and the short sleep duration and sleep disturbances of patients. Furthermore, patients with a history of heart disease or stroke are known to be at an increased risk for cancer, and our study indicates that their risk for cancer mortality is particularly elevated if they demonstrate short sleep duration, thus, this subgroup of patients may need closer monitoring than previously believed.”

Using the Penn State Adult Cohort, researchers analyzed 1,654 adults (mean age, 47.5 years; 47.5% men; 90% white), of whom 44% slept less than 6 hours, to understand the potential role of sleep duration in predicting mortality linked to cardiometabolic risk factors and cerebrovascular disease. The primary endpoint of cardiometabolic risk factors was defined as stage 2 hypertension and/or type 2 diabetes determined by BP and glucose levels or reported by diagnosis or treatment for either disease. The primary endpoint of cerebrovascular disease was defined by reported diagnosis of or treatment for heart disease and/or stroke.

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“This is an observational study of more than 1,600 adults followed up after about 20 years for their cause of death; it established an association but not a causal relationship, despite the fact that is known that the risk factors examined (hypertension, diabetes, heart disease and stroke) are indeed causes of death,” Fernandez-Mendoza told Healio. “We need experimental studies and randomized clinical trials testing the underlying mechanisms of the role of short sleep in the increased risk of mortality observed in these individuals with cardiovascular risk factors or diseases.” – by Scott Buzby

For more information:

Julio Fernandez-Mendoza, PhD, can be reached at 500 University Drive, Suite C5644C, Hershey, PA 17033; email: jfernandezmendoza@pennstatehealth.psu.edu.

Disclosures: The study was funded by the American Heart Association and the NHLBI. The authors report no relevant financial disclosures.