Sleep Duration and Quality: Impact on Lifestyle Behaviors and Cardiometabolic Health: A Scientific Statement From the American Heart Association

St‐Onge, Marie‐Pierre; Grandner, Michael A.; Brown, Devin L.; Conroy, Molly B.; Jean‐Louis, Girardin; Coons, Michael James; Bhatt, Deepak L.

doi:10.1161/cir.0000000000000444

Cited by 714 publications

(586 citation statements)

References 193 publications

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“…St‐Onge et al recently published a scientific statement on behalf of the American Heart Association 91. Their review surveyed the literature and found that sleep duration, mostly short sleep, and sleep disorders are related to adverse cardiometabolic risk, such as obesity, hypertension, type 2 diabetes mellitus, and CVD.…”

Section: Discussionmentioning

confidence: 99%

Self‐Reported Sleep Duration and Quality and Cardiovascular Disease and Mortality: A Dose‐Response Meta‐Analysis

Kwok

Kontopantelis

Kuligowski

et al. 2018

JAHA

314

227

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BackgroundThere is growing evidence that sleep duration and quality may be associated with cardiovascular harm and mortality.Methods and ResultsWe conducted a systematic review, meta‐analysis, and spline analysis of prospective cohort studies that evaluate the association between sleep duration and quality and cardiovascular outcomes. We searched MEDLINE and EMBASE for these studies and extracted data from identified studies. We utilized linear and nonlinear dose‐response meta‐analysis models and used DerSimonian–Laird random‐effects meta‐analysis models of risk ratios, with inverse variance weighting, and the I2 statistic to quantify heterogeneity. Seventy‐four studies including 3 340 684 participants with 242 240 deaths among 2 564 029 participants who reported death events were reviewed. Findings were broadly similar across both linear and nonlinear dose‐response models in 30 studies with >1 000 000 participants, and we report results from the linear model. Self‐reported duration of sleep >8 hours was associated with a moderate increased risk of all‐cause mortality, with risk ratio, 1.14 (1.05–1.25) for 9 hours, risk ratio, 1.30 (1.19–1.42) for 10 hours, and risk ratio, 1.47 (1.33–1.64) for 11 hours. No significant difference was identified for periods of self‐reported sleep <7 hours, whereas similar patterns were observed for stroke and cardiovascular disease mortality. Subjective poor sleep quality was associated with coronary heart disease (risk ratio, 1.44; 95% confidence interval, 1.09–1.90), but no difference in mortality and other outcomes.ConclusionsDivergence from the recommended 7 to 8 hours of sleep is associated with a higher risk of mortality and cardiovascular events. Longer duration of sleep may be more associated with adverse outcomes compared with shorter sleep durations.

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Section: Discussionmentioning

confidence: 99%

Self‐Reported Sleep Duration and Quality and Cardiovascular Disease and Mortality: A Dose‐Response Meta‐Analysis

Kwok

Kontopantelis

Kuligowski

et al. 2018

JAHA

314

227

View full text Add to dashboard Cite

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“…Women are more prone than men to depression, which is linked to insomnia 10. While the adverse effects of severe sleep disturbances, such as obstructive sleep apnea (OSA) and insufficient sleep, on metabolic and vascular health have recently been recognized in both men and women,11, 12, 13, 14 the effects of highly prevalent, milder sleep disturbances, such as perceived poor sleep quality and insomnia on vascular health, are not well characterized in women, a population particularly vulnerable to these conditions.…”

Section: Introductionmentioning

confidence: 99%

Effects of Inadequate Sleep on Blood Pressure and Endothelial Inflammation in Women: Findings From the American Heart Association Go Red for Women Strategically Focused Research Network

Aggarwal

Makarem

Shah

et al. 2018

JAHA

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BackgroundInsufficient sleep increases blood pressure. However, the effects of milder, highly prevalent but frequently neglected sleep disturbances, including poor sleep quality and insomnia, on vascular health in women are unclear. We investigated whether poor sleep patterns are associated with blood pressure and endothelial inflammation in a diverse sample of women.Methods and ResultsWomen who participated in the ongoing American Heart Association Go Red for Women Strategically Focused Research Network were studied (n=323, 57% minority, mean age=39±17 years, range=20–79 years). Sleep duration, sleep quality, and time to sleep onset were assessed using the Pittsburgh Sleep Quality Index (score ≥5=poor sleep quality). Risk for obstructive sleep apnea was evaluated using the Berlin questionnaire, and insomnia was assessed using the Insomnia Severity Index. In a subset of women who participated in the basic study (n=26), sleep duration was assessed objectively using actigraphy, and endothelial inflammation was assessed directly in harvested endothelial cells by measuring nuclear translocation of nuclear factor kappa B. Vascular reactivity was measured by brachial artery flow‐mediated dilation (n=26). Systolic and diastolic blood pressure were measured by trained personnel (n=323). Multivariable linear regressions were used to evaluate associations between sleep patterns and blood pressure, nuclear factor kappa B, and flow‐mediated dilation. Mean sleep duration was 6.8±1.3 hours/night in the population study and 7.5±1.1 hour/night in the basic study. In the population study sample, 50% had poor sleep quality versus 23% in the basic study, and 37% had some level of insomnia versus 15% in the basic study. Systolic blood pressure was associated directly with poor sleep quality, and diastolic blood pressure was of borderline significance with obstructive sleep apnea risk after adjusting for confounders (P=0.04 and P=0.08, respectively). Poor sleep quality was associated with endothelial nuclear factor kappa B activation (β=30.6; P=0.03). Insomnia and longer sleep onset latency were also associated with endothelial nuclear factor kappa B activation (β=27.6; P=0.002 and β=8.26; P=0.02, respectively). No evidence was found for an association between sleep and flow‐mediated dilation.ConclusionsThese findings provide direct evidence that common but frequently neglected sleep disturbances such as poor sleep quality and insomnia are associated with increased blood pressure and vascular inflammation even in the absence of inadequate sleep duration in women.Clinical Trial Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT02835261.

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“…The impact of sleep disorders on cardiovascular disease (CVD) and metabolic disorders is impressive. Recent epidemiological studies reinforce this association between sleep deprivation and the increase in the incidence of hypertension, obesity, coronary diseases, diabetes and dyslipidemia (1) . The presence of obstructive sleep apnea hypopnea syndrome (OSAHS) or insomnia significantly increase the risk of CVD (arrhythmias, atherosclerosis, coronary heart disease, heart failure, hypertension and stroke) and metabolic disorders (overweight, type 2 diabetes mellitus and dyslipidemia) (6)(7)(8) .…”

Section: Introductionmentioning

confidence: 86%

“…The increase in the rates of sleep disorders (SD) and its negative effects on cardiovascular disease has been raising interest in researchers from all over the world (1) . According to the American institute National Heart, Lung, and Blood Institute approximately 50 to 70 million adults suffer from sleep disturbance or report poor habitual sleep (2) .…”

Section: Introductionmentioning

confidence: 99%

Prevalence of sleep disorders in obese before bariatric surgery.

Carlos¹,

Oliver²,

Cruz³

et al. 2020

mtprehabjournal

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Introduction:The prevalence of sleep disorders (SD) has increased significantly in recent decades in parallel to the worldwide obesity epidemic. The presence of SD provides an increased risk of postoperative complications, requiring greater care in these patients. The gold standard for evaluation and diagnosis of SD is polysomnography, but it is an expensive and highly complex exam, making the questionnaires and scales more accessible for diagnosis and screening. Objectives: To evaluate the presence of SD and to analyze the influence of anthropometric measures on the scores of the Epworth Sleepiness Scale (ESS), snoring (ERS) and Stanford Sleepiness Scale (SSS) in obese patients. Method: An observational, cross-sectional study performed from August 2015 to August 2016. The patients in the preoperative group of bariatric surgery of the University Hospital were submitted to anthropometric evaluation and application of the ESS, ERS and SSS during the preoperative physiotherapy evaluation. Results: Were evaluated 100 obese (78 women), mean age of 41.4±10.7 years and BMI of 46.1±7.8kg/m 2 . SD were identified in 25% by ESS and 21% by SSS of obese. There were no differences between genders for the scales scores. The score of the ERS correlated itself with waist (r=0.20, p=0.04) and neck (r=0.33, p=0.001) circumferences. Conclusion: The use of scales for diagnosis of SD is useful in the follow-up of the preoperative of bariatric surgery and our study found that 25% of patients present daytime somnolence. We also observed the influence of waist and neck circumferences on increasing snoring scale.

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Sleep Duration and Quality: Impact on Lifestyle Behaviors and Cardiometabolic Health: A Scientific Statement From the American Heart Association

Cited by 714 publications

References 193 publications

Self‐Reported Sleep Duration and Quality and Cardiovascular Disease and Mortality: A Dose‐Response Meta‐Analysis

Self‐Reported Sleep Duration and Quality and Cardiovascular Disease and Mortality: A Dose‐Response Meta‐Analysis

Effects of Inadequate Sleep on Blood Pressure and Endothelial Inflammation in Women: Findings From the American Heart Association Go Red for Women Strategically Focused Research Network

Prevalence of sleep disorders in obese before bariatric surgery.

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