Short Sleep Duration Is Associated With Carotid Intima-Media Thickness Among Men in the Coronary Artery Risk Development in Young Adults (CARDIA) Study

Abstract

Background and purpose Carotid intima-media thickness (CIMT) is a subclinical marker of cardiovascular disease (CVD). Recent studies suggest that shorter sleep duration is a risk factor for CVD, but there is limited evidence regarding this association using high-quality, objective assessments of sleep. The aim of this study is to determine whether sleep duration is associated with CIMT. Methods The study used an observational cohort consisting of 617 black and white middle-aged healthy participants (37–52 y; 58% female) in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Multivariable-adjusted linear regression analyses were performed. Sleep duration was measured using wrist actigraphy monitors. CIMT was calculated using the average of 20 measurements of the mean common carotid, bulb and internal CIMT, which was assessed using ultrasound images. Results After adjusting for covariates, one hour of longer sleep duration was associated with 0.026 mm less CIMT among men (p=0.02, 95% CI -0.047, -0.005), and 0.001 mm less CIMT among women (p=0.91, 95% CI -0.020, 0.022). Segment-specific analyses indicated that the carotid bulb was a key driver of the observed association. Conclusions Shorter objectively assessed sleep duration was associated with greater CIMT among men but not women.

Associations of objectively measured and self‐reported sleep duration with carotid artery intima media thickness among police officers

“…Previous studies have reported inconsistent associations of self-reported and objectively measured sleep duration with IMT [Wolff et al, 2008; Abe et al, 2011; Nakazaki et al, 2012; Sands et al, 2012]. A U-shaped association between self-reported sleep duration and common carotid artery IMT found in one general population [Wolff et al, 2008] was not replicable in another general population [Abe et al, 2011].…”

“…To our knowledge, only four studies have reported findings on these associations. Two of them used objectively measured sleep duration and both found an inverse linear association between sleep duration and IMT [Nakazaki et al, 2012; Sands et al, 2012]. The linear trend in these two studies might be due to sleep categorization.…”

“…To remove the inherent association between sleep duration and the Pittsburgh Sleep Quality Index global score, component 3 (sleep duration) was subtracted from the global score when adjustment for sleep quality as a potential confounder was performed. A variable that was either associated with both sleep and IMT in the present analyses or has been recognized as a confounder in previous studies [Wolff et al, 2008; Cappuccio et al, 2011; Sands et al, 2012] was considered as a confounder for adjustment. Potential confounders included age, gender, race/ethnicity, abdominal height, systolic blood pressure, anti-hypertensive medications, glucose, LDL, HDL, lipid lowering medications, physical activity, alcohol consumption, perceived stress, a depressive symptom score, sleep quality, smoking status, shift work, and working a second job.…”

“…A U-shaped association between self-reported sleep duration and common carotid artery IMT found in one general population [Wolff et al, 2008] was not replicable in another general population [Abe et al, 2011]. Moreover, researchers have found an inverse linear association between objectively measured sleep duration and maximum IMT [Nakazaki et al, 2012; Sands et al, 2012]. …”

Relationship between carotid intima-media thickness, physical activity, sleep quality, metabolic/inflamatory profile, body fatness, smoking and alcohol consumption in young adults

“…In clinical practice, intima-media thickness, mainly carotid (CIMT), has been used as a marker of subclinical atherosclerosis 13 . In fact, increased CIMT has been associated with aging, but also with sleep disorders, such as obstructive sleep apnea, short sleep and long sleep 13,14 . However, the actual burden of sleep disorders over CIMT in young adults remains unclear because its progression is affected by other potential confounders, such as sex, age, and dyslipidemia 13 .…”