Multidimensional Sleep Health Is Associated with Cardiovascular Disease Prevalence and Cardiometabolic Health in US Adults

Abstract

Individual sleep dimensions have been linked to cardiovascular disease (CVD) risk and cardiometabolic health (CMH), but sleep health is multifaceted. We investigated associations of a multidimensional sleep health (MDSH) score, enabling the assessment of sleep health gradients, with CVD and CMH. Participants were 4555 adults aged ≥20 years from the 2017–2018 National Health and Nutrition Examination Survey. A MDSH score, capturing poor, moderate, and ideal sleep was computed from self-reported sleep duration, sleep regularity, difficulty falling asleep, symptoms of sleep disorders, and daytime sleepiness. Survey-weighted multivariable linear and logistic models examined associations of MDSH with CVD and CMH. Ideal and moderate vs. poor MDSH were related to lower odds of hypertension (62% and 41%), obesity (73% and 56%), and central adiposity (68% and 55%), respectively; a statistically significant linear trend was observed across gradients of MDSH (p-trend < 0.001). Ideal vs. moderate/poor MDSH was associated with 32% and 40% lower odds of prevalent CVD and type 2 diabetes, respectively. More favorable MDSH was associated with lower blood pressure, BMI, waist circumference, and fasting glucose. In sex-stratified analyses, ideal vs. moderate/poor MDSH was associated with lower CVD odds and blood pressure in women only. The MDSH framework may be more than just the sum of its parts and could better capture information regarding CVD risk.

The stress of losing sleep: Sex-specific neurobiological outcomes

“…Cardiovascular health is often affected by stress and is critically regulated by the sympathetic nervous system, and studies have more recently recognized sleep as an important contributor ( Malhotra and Loscalzo, 2009 ; Nagai et al, 2010 ; Somers et al, 2008 ; St-Onge et al, 2016 ). Taken together, these results indicate that women may be more vulnerable to negative cardiometabolic consequences of SleepDep ( Daugherty et al, 2020 ; Makarem et al, 2022 ).…”

Rest‐Activity Rhythms Are Associated With Prevalent Cardiovascular Disease, Hypertension, Obesity, and Central Adiposity in a Nationally Representative Sample of US Adults

“…A composite CVD outcome that included heart failure, coronary heart disease, angina/angina pectoris, heart attack, and stroke, obtained by self‐report on the medical conditions questionnaire, was created. 28 …”

“…The average of the first 3 measurements was used for the present analysis, consistent with prior work in NHANES. 28 Hypertension was defined as having systolic BP ≥130 mm Hg or diastolic BP ≥80 mm Hg or self‐reported use of any prescribed drugs to control BP, consistent with the 2017 American College of Cardiology/American Heart Association guidelines. 4 …”

Associations of a multidimensional polygenic sleep health score and a sleep lifestyle index on health outcomes and their interaction in a clinical biobank

“…Several recent studies have used composite sleep metrics to investigate the relationship between sleep and health outcomes. These include studies reporting associations between ‘unhealthy’ sleep scores, derived from self-report and actigraphy, and more depressive symptoms [5] and higher risk of cardiovascular conditions [6], and between ‘healthy’ sleep scores and better mental well-being [7], cardiometabolic health [8], and lower psychological distress [9].…”