Sleep health composites are associated with the risk of heart disease across sex and race

Abstract

We examined whether subjectively and objectively measured sleep health composites have a relationship with heart disease. 6,820 adults (Mage = 53.4 years) from the Midlife in the United States study provided self-reported sleep characteristics and heart disease history. A smaller sample (n = 663) provided actigraphy sleep data. We tested two sleep health composites, based on self-report only and both self-report and actigraphy, across multiple sleep dimensions. We used a weighted sum approach, where higher scores indicated more sleep health problems. Modified Poisson regressions adjusted for sociodemographics and known risk factors. Having more sleep health problems was associated with a higher risk of heart disease using the self-report sleep health composite (aRR = 54%, P < .001) and the actigraphy/self-report composite (aRR = 141%, P < .001). Individual sleep dimensions of satisfaction, alertness, and efficiency (from the self-report composite) and regularity, satisfaction, and timing (from the actigraphy/self-report composite) were associated with the risk of heart disease. The effect size of each sleep health composite was larger than the individual sleep dimensions. Race moderated the association between the actigraphy/self-report sleep health composite and heart disease. There was no significant moderation by sex. Findings suggest poorer sleep health across multiple dimensions may contribute to heart disease risk among middle-aged adults.

Effects of music interventions on sleep in people with dementia: A systematic review

“…For example, it is possible that a music intervention may not change the duration of sleep but may change other dimensions of sleep, such as regularity, satisfaction, alertness, timing, and/or efficiency among those with dementia (Buysse, 2014). Moreover, individuals with dementia may have multiple sleep problems (e.g., poor sleep quality + frequent napping/excessive daytime napping + less efficient sleep), which has not been fully understood by previous studies that mostly assessed single sleep variables (but see Brindle et al, 2019;Lee et al, 2022 for examples of multidimensional sleep health measures). This way, measuring single sleep variables may miss the opportunity to capture the potential effects of music interventions.…”

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

“…Indeed, in a cohort of ~9000 elderly US men and women, aged 65–99 years, poor self-reported MDSH was associated with a 2-fold higher risk for CVD mortality [ 16 ]. In the Midlife in the United States study, having more self-reported sleep problems was linked to 54% higher risk for heart disease in a cross-sectional analysis of 6,820 adults [ 17 ]. Similarly, in the UK Biobank Study, every 1 unit increase in a 5-point sleep health score based on self-reported sleep duration, chronotype, insomnia symptoms, snoring, and excessive daytime sleepiness was related to 15% lower risk of heart failure over a median follow-up of 10 years [ 28 ].…”

“…MDSH has been linked to lower risk of CVD mortality in elderly adults [ 16 ] and to lower heart disease prevalence in midlife adults [ 17 ], but associations with both prevalent CVD and cardiometabolic risk factors that underlie the continuum of chronic disease and predispose to CVD have not been previously evaluated in a nationally representative cohort of US adults. Further, relations of MDSH scores, that could be easily ascertained in a clinic or public health setting, with odds of having obesity, T2D, and HTN, the leading contributors to CVD morbidity and mortality, have not been previously evaluated.…”

Gender dimension in cardio-pulmonary continuum

“…Another is that chronic psychosocial stress or job shifts may result in activating the autonomic nervous or immune system which may increase the risk for CVD ( 38 ). According to Lee et al ( 39 ) sleep deprivation also increases the risk of CVD by reducing productivity and immune function which can lead to social concerns with friends and family. The same group further noted that lack of sleep has been associated with depressive symptoms in older women and death in older men.…”

“…The same group further noted that lack of sleep has been associated with depressive symptoms in older women and death in older men. Sleep quality, duration, and CVD seem to be influenced by sex, and women have been noted to suffer more from insomnia than males due to hormonal changes affecting the circadian rhythm ( 39 ).…”