Association of sleep-related disorders with cardiovascular disease among adults in the United States: A cross-sectional study based on national health and nutrition examination survey 2005–2008

Abstract

Background and objectiveThe association between sleep-related disorders and cardiovascular diseases (CVDs) remains controversial and lacks epidemiological evidence in the general population. We investigated whether sleep-related disorders are related to CVDs in a large, nationally representative, diverse sample of American adults.Materials and methodsData were collected from the National Health and Nutrition Examination Survey (NHANES) 2005–2008. Logistic regression was performed to explore associations of sleep-related disorders with the prevalence of total and specific CVDs. Stratified subgroup analysis was performed to exclude interactions between variables and sleep-related disorders. Non-linearity was explored using restricted cubic splines.ResultsIn total, 7,850 participants aged over 20 years were included. After controlling for confounders, multivariate regression analysis showed that sleep problems were associated increases in risk of 75% for CVD (OR: 1.75; 95% CI 1.41, 2.16), 128% for congestive heart failure (CHF) (OR: 2.28; 95% CI 1.69, 3.09), 44% for coronary heart disease (CHD) (OR: 1.44; 95% CI 1.12, 1.85), 96% for angina pectoris (AP) (OR: 1.96; 95% CI 1.40, 2.74), 105% for heart attack (OR: 2.05; 95% CI 1.67, 2.53) and 78% for stroke (OR: 1.78; 95% CI 1.32, 2.40). Daytime sleepiness was associated increases in risk of 54% for CVD (OR: 1.54; 95% CI 1.25, 1.89), 73% for CHF (OR: 1.73; 95% CI 1.22, 2.46), 53% for AP (OR: 1.53; 95% CI 1.12, 2.10), 51% for heart attack (OR: 1.51; 95% CI 1.18, 1.95), and 60% for stroke (OR: 1.60; 95% CI 1.09, 2.36). Participants with insufficient sleep had a 1.42-fold higher likelihood of CVD (OR: 1.42; 95% CI 1.13, 1.78) and a 1.59-fold higher likelihood of heart attack (OR: 1.59; 95% CI 1.19, 2.13) than participants with adequate sleep. Prolonged sleep-onset latency was associated with an increased risk of CVD (OR: 1.59; 95% CI 1.17, 2.15), CHF (OR: 2.08; 95% CI 1.33, 3.23) and heart attack (OR: 1.76; 95% CI 1.29, 2.41). Short sleep-onset latency was associated with a 36% reduction in stroke risk (OR: 0.64; 95% CI 0.45, 0.90). The association of sleep problems with CVD risk was more pronounced in the group younger than 60 years (p for interaction = 0.019), and the relationship between short sleep-onset latency and total CVD differed by sex (p for interaction = 0.049). Additionally, restricted cubic splines confirmed a linear relationship between sleep-onset latency time and CVD (p for non-linearity = 0.839) and a non-linear relationship between sleep duration and CVD (p for non-linearity <0.001).ConclusionAccording to a limited NHANES sample used to examine sleep-related disorders and CVD, total and specific CVDs could be associated with certain sleep-related disorders. Additionally, our study uniquely indicates that CVD risk should be considered in participants younger than 60 years with sleep problems, and shortened sleep-onset latency may be a CVD protective factor in females.

Self-Reported Sleep Disturbance is an Independent Predictor of All-Cause Mortality and Respiratory Disease Mortality in US Adults: A Population-Based Prospective Cohort Study

“…In our stratified analysis and interaction analysis, we found that after all other covariates were adjusted, the association of self-reported sleep disturbance with all-cause mortality was more pronounced in a population of less than 60 years old and the interaction with age is statistically significant. This is consistent with previous research ( 45 , 55 ), and the possible reasons are that bad habits, such as more sedentary time, more screen use time, and more sleep deprivation appear more in young adults and were not adjusted in the model; then similarly the higher prevalence of chronic diseases in senior adults weaken the effect of sleep disturbance since they were adjusted in the model. Recent research indicated that poor sleep behavior is independently associated with an increased risk of subclinical multi-territory atherosclerosis in middle-aged participants free of known CVD history ( 56 ), suggesting that sleep disturbance in the seemingly healthy population should be noticeable to public health practitioners.…”

“…Many researchers have demonstrated that sleep disorders could promote the incidence of CVD and its mortality ( 7 , 40 , 45 ), possibly by increasing adverse cardiometabolic risk ( 39 , 46 ), and healthy sleep behavior is recommended to promote ideal cardiac health, along with efforts to address other established risk factors including blood pressure, cholesterol, diet, blood glucose, physical activity, weight, and smoking cessation ( 46 ). However, in our fully adjusted model, the HR of self-reported sleep disturbance to CVD mortality did not reach the statistical significance level.…”

Changes in sleep quality and sleep disturbances in the general population from before to during the COVID-19 lockdown: A systematic review and meta-analysis

“…Poor sleep quality has in fact been associated with a higher risk of type 2 diabetes ( 93 ), overweight/obesity ( 94 ), metabolic syndrome ( 95 ) and depressive and anxiety symptoms ( 96 , 97 ). Similarly, a prolonged sleep onset latency has been associated with metabolic syndrome ( 95 ), and with an increased risk of cardiovascular disease (CVD) ( 98 ), and depressive symptoms ( 99 ). Finally, poor sleep efficiency is associated with a higher risk of incident CVD ( 100 ) and depression ( 101 ).…”

Навіщо Дбати Про Душевну Рівновагу Кардіологічних Пацієнтів?

“…У перехресне дослідження, засноване на Національному дослідженні здоров'я та харчування (NHANES) 2005-2008 рр., були включені 7850 учасників віком від 20 років. Багатофакторний регресійний аналіз показав, що проблеми зі сном пов'язані зі збільшенням ризику ССЗ на 75 %, застійної СНна 128 стенокардії -на 96 %, ІМ -на 105 %, інсульту -на 78 % [72].…”