Sleep irregularity increases CVD risk
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Excess variations in sleep duration and timing were associated with an increased risk for CVD independent of sleep quantity and/or quality and traditional CVD risk factors, according to a study published in the Journal of the American College of Cardiology.
“Providers may [communicate] with their patients regarding the potential benefits of regular sleep schedules in cardiometabolic disease prevention beyond sufficient sleep duration and other healthy lifestyles such as exercise,” Tianyi Huang, MSc, ScD, assistant professor of medicine and associate epidemiologist at Brigham and Women’s Hospital and Harvard Medical School, told Healio.
MESA cohort data
Researchers analyzed data from 1,992 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort who were free from CVD at baseline. The sleep examination portion of this study included a night of at-home polysomnography, wrist actigraphy for 7 days and a questionnaire to report on sleep-related traits and sleep habits.
The primary endpoint was incident total CVD events, which included CHD death, MI, angina followed by revascularization, resuscitated cardiac arrest, stroke death, stroke and other CVD or atherosclerotic deaths.
During a median follow-up of 4.9 years, 111 incident total CVD events occurred.
Compared with a standard deviation of 60 minutes or less of sleep duration, the risk for total CVD increased at a standard deviation of 61 to 90 minutes (HR = 1.09; 95% CI, 0.62-1.92), a standard deviation of 91 to 120 minutes (HR = 1.59; 95% CI, 0.91-2.76) and a standard deviation of greater than 120 minutes (HR = 2.14; 95% CI, 1.24-3.68; P for trend = .002).
A similar association was seen with sleep timing. When compared with a sleep-onset timing standard deviation of 30 minutes or less, the risk for CVD increased at a standard deviation of 31 to 60 minutes (HR = 1.16; 95% CI, 0.64-2.13), a standard deviation of 61 minutes to 90 minutes (HR = 1.52; 95% CI, 0.81-2.88) and a standard deviation of greater than 90 minutes (HR = 2.11; 95% CI, 1.13-3.91; P for trend = .002).
Similar results were observed when current shift workers were excluded.
“Larger studies are needed to confirm the findings and to understand the underlying mechanisms,” Huang said in an interview. “If confirmed, intervention studies are warranted to test whether reducing sleep irregularity can improve cardiovascular health.”
‘Crucial step in this process’
In a related editorial, Olaf Oldenburg, MD, chief physician in the department of cardiology at Clemenshospital in Münster, Germany, and Jens Spiesshoefer, MD, postdoctoral researcher in the department of neurology with Institute for Translational Neurology at University Hospital Muenster in Germany, wrote: “Dysfunctional sleep likely is by far the most prevalent comorbidity in CVD. This makes it essential to explore the nature of sleep, but this is reliant on the enthusiasm of clinician scientists. The study by Huang et al is undoubtedly a crucial step in this process.” – by Darlene Dobkowski
For more information:
Tianyi Huang, MSc, ScD, can be reached at tih541@mail.harvard.edu; Twitter: @thuang87.
Disclosures: Huang and Oldenburg report no relevant financial disclosures. Spiesshoefer reports he received travel grants and lecture honoraria from Boehringer Ingelheim and Chiesi. Please see the study for all other authors’ relevant financial disclosures.
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Huang T, et al. J Am Coll Cardiol. 2020;doi:10.1016/j.jacc.2019.12.054.
Oldenburg O, et al. J Am Coll Cardiol. 2020;doi:10.1016/j.jacc.2019.12.055.
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