Daytime sleepiness and risk of coronary heart disease and stroke: results from the Nurses’ Health Study II

Abstract

Objective The objective of this study was to determine whether daytime sleepiness is independently associated with coronary heart disease (CHD) and stroke or whether the positive association is explained by short sleep duration, disturbed sleep, and circadian disruption, conditions that are associated with cardiometabolic risk factors for vascular events. Methods Longitudinal analyses of data from the Nurses’ Health Study II comprising 84,003 female registered nurses aged 37–54 at baseline were conducted in 2001 with follow-up until 2009. Multivariate Cox regression was used to explore the relationship between reported daytime sleepiness and the incidence of either CHD or stroke (n = 500 cases). Results Women who reported daytime sleepiness almost every day, compared with rarely/never, had an elevated adjusted risk of cardiovascular disease (CVD) (hazard ratio (HR) = 1.58, 95% confidence interval (CI) 1.15–2.17). Controlling for sleep variables (sleep duration, snoring, shift work, and sleep adequacy) or potential metabolic biological mediators of disrupted sleep (diabetes, hypercholesterolemia, and hyper-tension) appreciably attenuated the relationship (HR = 1.17, 95% CI 0.84–1.65; and HR = 1.34, 95% CI 0.97–1.85, respectively). Controlling for both sleep variables and metabolic risk factors eliminated an independent association (HR = 1.09, 95% CI 0.77–1.53). A similar pattern was observed for CHD and stroke individually. Conclusions Daytime sleepiness was not an independent risk factor for CVD in this cohort of women, but rather, was associated with sleep characteristics and metabolic abnormalities that are risk factors for CVD.

Excessive Daytime Sleepiness Independently Predicts Increased Cardiovascular Risk After Myocardial Infarction

“…The prognostic value of EDS in post-MI patients is a novel finding and is consistent with previous studies in non-MI patients, [5][6][7] although other investigations did not report significant correlation of EDS with CVD prevalence in a cross-sectional study 20 or incidence of new-onset CVD in longitudinal observation. 21 A number of factors have been hypothesized as accounting for the unfavorable cardiovascular profile in sleepy individuals. First, EDS is closely associated with traditional cardiovascular risk factors, such as obesity, diabetes mellitus, uncontrolled hypertension, and physical inactivity.…”

Snoring Characteristics Inventory and Blood Pressure: Window Assessment Tool for Obstructive Sleep Apnea and Cardiovascular Risk

“…Sleepiness occurs as a post effect of the snoring activity. The person wakes up with a dry mouth and throat, headache, fatigue and sleepiness throughout the day, together with some memory deficiency, poor attention and concentration, lack of sleep, due to sleep apnea [3]. Moreover, daytime sleepiness could be symptomatic of insufficient sleep, disturbed sleep, and/or circadian disruption that in turn increase the risk of vascular events.…”

Sleep duration associated with cardiovascular conditions among adult Nevadans

“…Various studies have assessed associations between sleep duration versus sleep insufficiency and cardiometabolic outcomes, general sleep disturbance and cardiovascular diseases, daytime sleepiness as a risk factor for CVD, and sleep duration, quality and CVD morality among the elderly (Altman et al, 2012;Grandner, Jackson, Pak & Gehrman, 2012;Gangwisch et al, 2014;Suzuki et al, 2009). Short and long sleep duration have both been variably cited as potential risk factors for cardiovascular diseases, yet an assorted studies repetitively state uncertain association and causality.…”