A Prospective Study of Sleep Duration and Coronary Heart Disease in Women

Ayas, Najib; White, David P.; Manson, JoAnn E.; Stampfer, Meir J.; Speizer, Frank E.; Malhotra, Atul; Hu, Frank B.

doi:10.1001/archinte.163.2.205

Cited by 964 publications

(692 citation statements)

References 13 publications

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“…A total of 74 studies met the inclusion criteria; the process of study selection is shown in Figure 1 8, 9, 11, 12, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89,...…”

Section: Resultsmentioning

confidence: 99%

Self‐Reported Sleep Duration and Quality and Cardiovascular Disease and Mortality: A Dose‐Response Meta‐Analysis

Kwok

Kontopantelis

Kuligowski

et al. 2018

JAHA

282

192

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BackgroundThere is growing evidence that sleep duration and quality may be associated with cardiovascular harm and mortality.Methods and ResultsWe conducted a systematic review, meta‐analysis, and spline analysis of prospective cohort studies that evaluate the association between sleep duration and quality and cardiovascular outcomes. We searched MEDLINE and EMBASE for these studies and extracted data from identified studies. We utilized linear and nonlinear dose‐response meta‐analysis models and used DerSimonian–Laird random‐effects meta‐analysis models of risk ratios, with inverse variance weighting, and the I2 statistic to quantify heterogeneity. Seventy‐four studies including 3 340 684 participants with 242 240 deaths among 2 564 029 participants who reported death events were reviewed. Findings were broadly similar across both linear and nonlinear dose‐response models in 30 studies with >1 000 000 participants, and we report results from the linear model. Self‐reported duration of sleep >8 hours was associated with a moderate increased risk of all‐cause mortality, with risk ratio, 1.14 (1.05–1.25) for 9 hours, risk ratio, 1.30 (1.19–1.42) for 10 hours, and risk ratio, 1.47 (1.33–1.64) for 11 hours. No significant difference was identified for periods of self‐reported sleep <7 hours, whereas similar patterns were observed for stroke and cardiovascular disease mortality. Subjective poor sleep quality was associated with coronary heart disease (risk ratio, 1.44; 95% confidence interval, 1.09–1.90), but no difference in mortality and other outcomes.ConclusionsDivergence from the recommended 7 to 8 hours of sleep is associated with a higher risk of mortality and cardiovascular events. Longer duration of sleep may be more associated with adverse outcomes compared with shorter sleep durations.

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Section: Resultsmentioning

confidence: 99%

Self‐Reported Sleep Duration and Quality and Cardiovascular Disease and Mortality: A Dose‐Response Meta‐Analysis

Kwok

Kontopantelis

Kuligowski

et al. 2018

JAHA

282

192

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“…The findings associated with short sleep have important implications for preventive medicine and public health, given that short sleep is associated with cardiovascular disease (Ayas et al, 2003, Gangwisch et al, 2006, Gottlieb et al, 2006and Shankar et al, 2008, depression (Krueger and Friedman, 2009), obesity (Gangwisch et al, 2005, Singh et al, 2005, Patel and Hu, 2008and van den Berg et al, 2008 and elevated mortality. These chronic health conditions could cause short sleep because of discomfort, pain and/or the side effects of medication (Moldofsky, 2001).…”

Section: Discussionmentioning

confidence: 99%

“…These chronic health conditions could cause short sleep because of discomfort, pain and/or the side effects of medication (Moldofsky, 2001). Some longitudinal data also demonstrate that short sleep could contribute to these conditions (Ayas et al, 2003, Gangwisch et al, 2005, Gangwisch et al, 2006, Patel et al, 2006a, Patel et al, 2006b, Chaput et al, 2008and Shankar et al, 2008 possibly by altering sympathetic nervous system activity, neuroendocrine function and/or hypothalamic-pituitary-adrenal axis activity (Leproult et al, 1997, Spiegel et al, 2004and Van Cauter et al, 2007. However, more research is required to investigate the role of short sleep as a risk factor for chronic disease.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with short and long sleep

Magee

Iverson

Caputi

2009

Preventive Medicine

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Objective: Short (< 7 h) and long sleep durations (≥ 9 h) have recently been linked with increased mortality in the US, Europe and Asia, but little is known about the sleep patterns of Australian adults. The present study examined the sleep habits of Australian adults and identified socio-demographic and health-related factors associated with short and long sleep. Methods: This study analyzed cross-sectional and self-reported data from 49,405 Australian adults aged 45 to 65 years collected between 2006 and 2008. Socio-demographic and health-related factors were entered into multinomial logistic regression models predicting self-reported sleep duration. Results: Short and long sleep were reported by 16.6% and 13.9% of participants respectively. Short sleep was associated with long working hours (odds ratio [OR] = 1.17, 95% confidence interval (CI): 1.08, 1.28) and obesity (OR = 1.29, 95% CI: 1.19, 1.41); long sleep was associated with recent treatment for cancer (OR = 1.64, 95% CI: 1.34, 2.02) and heart attack/angina (OR = 1.58, 95% CI: 1.19, 2.09). Conclusions: Short and long sleep were common in this sample of middle aged Australian adults. The determinants of short sleep have potential public health implications and could be targeted to prevent morbidity and mortality associated with short sleep. confidence interval (CI): 1.08, 1.28) and obesity (OR = 1.29, 95% CI: 1.19, 1.41); long sleep was associated with recent treatment for cancer (OR = 1.64, 95% CI: 1.34, 2.02) and heart attack/angina (OR = 1.58, 95% CI: 1.19, 2.09). Conclusions: Short and long sleep were common in this sample of middle aged Australian adults. The determinants of short sleep have potential public health implications and could be targeted to prevent morbidity and mortality associated with short sleep.

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“…Inadequate sleep is common, with 28% of the US adult population reporting ≤6 hours of sleep per night and with that, a corresponding 24% increased risk of cardiovascular disease 1, 2, 3, 4, 5, 6, 7. Women adopt such behavior in disproportionately greater numbers in part because of lifelong demands on them as caregivers, first to their children and later to ailing and/or elderly family members 8, 9.…”

Section: Introductionmentioning

confidence: 99%

Effects of Inadequate Sleep on Blood Pressure and Endothelial Inflammation in Women: Findings From the American Heart Association Go Red for Women Strategically Focused Research Network

Aggarwal

Makarem

Shah

et al. 2018

JAHA

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BackgroundInsufficient sleep increases blood pressure. However, the effects of milder, highly prevalent but frequently neglected sleep disturbances, including poor sleep quality and insomnia, on vascular health in women are unclear. We investigated whether poor sleep patterns are associated with blood pressure and endothelial inflammation in a diverse sample of women.Methods and ResultsWomen who participated in the ongoing American Heart Association Go Red for Women Strategically Focused Research Network were studied (n=323, 57% minority, mean age=39±17 years, range=20–79 years). Sleep duration, sleep quality, and time to sleep onset were assessed using the Pittsburgh Sleep Quality Index (score ≥5=poor sleep quality). Risk for obstructive sleep apnea was evaluated using the Berlin questionnaire, and insomnia was assessed using the Insomnia Severity Index. In a subset of women who participated in the basic study (n=26), sleep duration was assessed objectively using actigraphy, and endothelial inflammation was assessed directly in harvested endothelial cells by measuring nuclear translocation of nuclear factor kappa B. Vascular reactivity was measured by brachial artery flow‐mediated dilation (n=26). Systolic and diastolic blood pressure were measured by trained personnel (n=323). Multivariable linear regressions were used to evaluate associations between sleep patterns and blood pressure, nuclear factor kappa B, and flow‐mediated dilation. Mean sleep duration was 6.8±1.3 hours/night in the population study and 7.5±1.1 hour/night in the basic study. In the population study sample, 50% had poor sleep quality versus 23% in the basic study, and 37% had some level of insomnia versus 15% in the basic study. Systolic blood pressure was associated directly with poor sleep quality, and diastolic blood pressure was of borderline significance with obstructive sleep apnea risk after adjusting for confounders (P=0.04 and P=0.08, respectively). Poor sleep quality was associated with endothelial nuclear factor kappa B activation (β=30.6; P=0.03). Insomnia and longer sleep onset latency were also associated with endothelial nuclear factor kappa B activation (β=27.6; P=0.002 and β=8.26; P=0.02, respectively). No evidence was found for an association between sleep and flow‐mediated dilation.ConclusionsThese findings provide direct evidence that common but frequently neglected sleep disturbances such as poor sleep quality and insomnia are associated with increased blood pressure and vascular inflammation even in the absence of inadequate sleep duration in women.Clinical Trial Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT02835261.

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A Prospective Study of Sleep Duration and Coronary Heart Disease in Women

Abstract: Short and long self-reported sleep durations are independently associated with a modestly increased risk of coronary events.

Cited by 964 publications

References 13 publications

Self‐Reported Sleep Duration and Quality and Cardiovascular Disease and Mortality: A Dose‐Response Meta‐Analysis

Self‐Reported Sleep Duration and Quality and Cardiovascular Disease and Mortality: A Dose‐Response Meta‐Analysis

Factors associated with short and long sleep

Effects of Inadequate Sleep on Blood Pressure and Endothelial Inflammation in Women: Findings From the American Heart Association Go Red for Women Strategically Focused Research Network

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