Sleep Duration and Insomnia in the Elderly: Associations With Blood Pressure Variability and Carotid Artery Remodeling

Nagai, Michiaki; Hoshide, Satoshi; Nishikawa, Mami; Shimada, Kazuyuki

doi:10.1093/ajh/hpt070

Cited by 52 publications

(41 citation statements)

References 32 publications

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“…Sleep duration and sleep quality are two distinct parameters of sleep, and these are discussed separately along with each non-invasive marker of subclinical CVD in respective tables. Five studies evaluated association of sleep parameters with coronary artery calcium (CAC) 17, 31–34) , eight evaluated association with carotid intima-media thickness (CIMT) 2, 35–41) , thirteen evaluated association with endothelial function 42–54) , and six studies assessed relationship with arterial stiffness 17, 55–58) . Kim et al .…”

Section: Resultsmentioning

confidence: 99%

“…An estimated 50–70 million Americans suffer from sleep disorders, yet only 20% report it to their physicians 1) . Poor sleep may be a risk factor for cardiovascular disease (CVD) and has serious biological consequences 2) . A growing body of literature suggests a relationship of sleep parameters (sleep duration and sleep quality) with CVD, stroke, and all-cause morbidity & mortality 3) .…”

Section: Introductionmentioning

confidence: 99%

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Association of Subjective and Objective Sleep Duration as well as Sleep Quality with Non-Invasive Markers of Sub-Clinical Cardiovascular Disease (CVD): A Systematic Review

Aziz

Ali

Das

et al. 2017

J Atheroscler Thromb

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Aim: Abnormal daily sleep duration and quality have been linked to hypertension, diabetes, stroke, and overall cardiovascular disease (CVD) morbidity & mortality. However, the relationship between daily sleep duration and quality with subclinical measures of CVD remain less well studied. This systematic review evaluated how daily sleep duration and quality affect burden of subclinical CVD in subjects free of symptomatic CVD.Methods: Literature search was done via MEDLINE, EMBASE, Web of Science until June 2016 and 32 studies met the inclusion criteria. Sleep duration and quality were measured either via subjective methods, as self-reported questionnaires or Pittsburg Sleep Quality Index (PSQI) or via objective methods, as actigraphy or polysomnography or by both. Among subclinical CVD measures, coronary artery calcium (CAC) was measured by electron beam computed tomography, Carotid intima-media thickness (CIMT) measured by high-resolution B-mode ultrasound on carotid arteries, endothelial/microvascular function measured by flow mediated dilation (FMD) or peripheral arterial tone (PAT) or iontophoresis or nailfold capillaroscopy, and arterial stiffness measured by pulse wave velocity (PWV) or ankle brachial index (ABI).Results: Subjective short sleep duration was associated with CAC and CIMT, but variably associated with endothelial dysfunction (ED) and arterial stiffness; however, subjective long sleep duration was associated with CAC, CIMT and arterial stiffness, but variably associated with ED. Objective short sleep duration was positively associated with CIMT and variably with CAC but not associated with ED. Objective long sleep duration was variably associated with CAC and CIMT but not associated with ED. Poor subjective sleep quality was significantly associated with ED and arterial stiffness but variably associated with CAC and CIMT. Poor objective sleep quality was significantly associated with CIMT, and ED but variably associated with CAC.Conclusions: Overall, our review provided mixed results, which is generally in line with published literature, with most of the studies showing a significant relationship with subclinical CVD, but only some studies failed to demonstrate such an association. Although such mechanistic relationship needs further evaluation in order to determine appropriate screening strategies in vulnerable populations, this review strongly suggested the existence of a relationship between abnormal sleep duration and quality with increased subclinical CVD burden.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association of Subjective and Objective Sleep Duration as well as Sleep Quality with Non-Invasive Markers of Sub-Clinical Cardiovascular Disease (CVD): A Systematic Review

Aziz

Ali

Das

et al. 2017

J Atheroscler Thromb

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“…In turn, a dysregulated sleep/wake cycle may lead to greater circulating levels of pro-inflammatory biomarkers that affect hemodynamics. Indeed, case-control studies have shown that diagnosed insomnia was related to blunted nocturnal blood pressure dipping (Lanfranchi et al, 2009), impaired heart rate variability (Spiegelhalder et al, 2011), constant cardiac sympathetic hyperactivation at night (de Zambotti et al, 2013), and greater carotid intima media thickness (Nagai et al, 2013). Thus, neuroendocrine dysregulation, poor sleep behaviors, and mental health disturbances in response to childhood abuse likely lead to persistent sleep disturbances, which in turn incite an inflammatory response that affects vasculature functioning and structure.…”

Section: Discussionmentioning

confidence: 99%

Linking childhood abuse and hypertension: sleep disturbance and inflammation as mediators

2016

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The indirect association of childhood abuse with prevalent hypertension in adulthood through sleep disturbance and pro-inflammatory biomarkers was investigated in 589 community-dwelling, middle-aged adults. Participants completed the Childhood Trauma Questionnaire and self-reported current sleep disturbance and medical diagnoses including hypertension. Blood pressure was taken and blood samples were analyzed for C-reactive protein, interleukin-6, and fibrinogen. Hypertension was present in 41.3% of the sample. In the full multiple mediation model, tested using structural equation modeling, all hypothesized pathways were significant (p’s < 0.05). Childhood abuse was significantly related to both body mass index and sleep disturbance, which, both in turn, were significantly associated with inflammation, which was subsequently associated with hypertension status. The model demonstrated good fit (χ2 (122) = 352.0, p <0.001, CFI = 0.918, RMSEA = 0.057) and the indirect effect of all mediators was significant (Indirect Effect: 0.02, 95%CI: 0.005−0.03, p = 0.001). Sleep disturbance, body mass, and inflammation may be independent, intermediate steps between childhood abuse and subsequent hypertension that may be amenable to biobehavioral interventions.

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“…In elderly patients at high risk for cardiovascular disease, long sleep duration and persistent insomnia each had synergetic interactions with carotid artery stiffness and with visitto-visit BP variability. 23 Thus, optimal sleep duration and good sleep quality are favorable for good prognosis of hypertensive patients.…”

mentioning

confidence: 99%

Depression in hypertension and blood pressure variability over shorter time periods

Kabutoya

Kario

2015

Hypertens Res

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Sleep Duration and Insomnia in the Elderly: Associations With Blood Pressure Variability and Carotid Artery Remodeling

Cited by 52 publications

References 32 publications

Association of Subjective and Objective Sleep Duration as well as Sleep Quality with Non-Invasive Markers of Sub-Clinical Cardiovascular Disease (CVD): A Systematic Review

Association of Subjective and Objective Sleep Duration as well as Sleep Quality with Non-Invasive Markers of Sub-Clinical Cardiovascular Disease (CVD): A Systematic Review

Linking childhood abuse and hypertension: sleep disturbance and inflammation as mediators

Depression in hypertension and blood pressure variability over shorter time periods

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