Sleep duration, baseline cardiovascular risk, inflammation and incident cardiovascular mortality in ambulatory U.S. Adults: National health and nutrition examination survey

Abstract

Introduction The interplay between sleep duration and inflammation on the baseline and incident cardiovascular (CV) risk is unknown. We sought to evaluate the association between sleep duration, C-reactive protein (CRP), baseline CV risk, and incident CV mortality. Methods We used data from the National Health and Nutrition Examination Survey 2005–2010 linked with the cause of death data from the National Center for Health Statistics for adults aged ≥18 years. The associations between self-reported sleep duration and CRP, 10-year atherosclerotic CV disease risk score (ASCVD) and CV mortality were assessed using Linear, Poisson and Cox proportional hazard modeling as appropriate. Results There were 17,635 eligible participants with a median age of 46 years (interquartile range [IQR] 31, 63). Among them, 51.3% were women and 46.9% were non-Hispanic Whites. Over a median follow-up of 7.5 years (IQR 6.0, 9.1), 350 CV deaths occurred at an incident rate of 2.7 per 1000-person years (IQR 2.4, 3.0). We observed a U–shaped associations between sleep duration and incident CV mortality rate ( P -trend=0.011), sleep duration and 10-year ASCVD risk ( P -trend <0.001), as well as sleep duration and CRP ( P -trend <0.001). A self-reported sleep duration of 6-7 hours appeared most optimal. We observed that those participants who reported <6 or >7 hours of sleep had higher risk of CV death attributable to inflammation after accounting for confounders. Conclusions There was a U-shaped relationship of incident CV mortality, 10-year ASCVD risk, and CRP with sleep duration. These findings suggest an interplay between sleep duration, inflammation, and CV risk.

Evaluation of Temporal Trends in Racial and Ethnic Disparities in Sleep Duration Among US Adults, 2004-2018

“…Nonetheless, the potential 20-minute difference in self-reported sleep duration accuracy between White and Black individuals would only minimally explain the disparity between them, as suggested by our sensitivity analysis. Furthermore, self-reported sleep duration has important health implications, including consistent association with mortality across different populations and across racial and ethnic groups in the US . In addition, for the entire study period, we lacked other information that may have provided a more in-depth understanding of these disparities in sleep health, including subjective sleep quality, efficiency, and timing .…”

“…Furthermore, self-reported sleep duration has important health implications, including consistent association with mortality across different populations 49,[58][59][60][61] and across racial and ethnic groups in the US. 62 In addition, for the entire study period, we lacked other information that may have provided a more in-depth understanding of these disparities in sleep health, including subjective sleep quality, efficiency, and timing.…”

The DBST Index, the Discrepancy Between Desired Time in Bed and Desired Total Sleep Time: The Possible New Sleep Index Predicting Severity of Insomnia

“…In general, 7-8 h of sleep is recommended for adults. Numerous studies have shown a U-shaped relationship between self-reported sleep length and physical health such as hypertension [2], obesity [3], metabolic syndrome [4], stroke [5], cardiovascular risk [6], and all-cause mortality [7][8][9], and even mental health factors, including depression [10] and cognitive impairment [11]. Although the harmful effect of long sleep duration is controversial [12], the harmful effect of short sleep duration is well known.…”

The DBST index - Discrepancy between desired time in bed and desired total sleep time: A pilot study for the possible new sleep index predicting severity of insomnia

“…In general, 7-8 hours of sleep are recommended for adults. Numerous studies have shown a U-shaped relationship between self-reported sleep length and physical health such as hypertension (2), obesity (3), metabolic syndrome (4), stroke (5), cardiovascular risk (6), and all-cause mortality (7-9), and even mental health factors, including depression (10) and cognitive impairment (11). Although the harmful effect of long sleep duration is controversial (12), the harmful effect of short sleep duration is well known.…”