Sleeping Difficulty and Subjective Short Sleep Duration are Associated with Serum N-terminal Pro-brain Natriuretic Peptide Levels in the Elderly Population

Abstract

Objective It is well known that poor sleep increases the risk of heart failure (HF). However, the underlying mechanisms remain unclear. In this study, we investigated the association of poor sleep with hemodynamic stress on the left ventricle, which was a key factor for the development of HF in elderly individuals. Methods A total of 2,301 participants (≥65 years old) without cardiac disease were enrolled in this cross-sectional analysis. We evaluated the subjective sleep quality, sleeping difficulty, subjective sleep duration, use of sleeping pills, and daytime dysfunction using the Pittsburgh Sleep Quality Index, a 19-item self-reported questionnaire. We assessed serum N-terminal pro-brain natriuretic peptide (NT-proBNP) as a marker of hemodynamic stress on the left ventricle, and we defined high NT-proBNP as a serum NT-proBNP level ≥ 125 pg/mL. Results Sleeping difficulty was significantly associated with high NT-proBNP levels [odds ratio (OR), 1.46; 95% confidence interval (CI), 1.16-1.85; p<0.005]. A subjective short sleep duration was also significantly associated with high NT-proBNP levels (OR, 1.69; 95% CI, 1.03-2.75; p<0.05). A subjective poor sleep quality, the use of sleeping pills, and daytime dysfunction were not associated with serum NT-proBNP levels. All data were adjusted for the age, sex, body mass index, serum hemoglobin concentration, serum creatinine level, systolic blood pressure, diastolic blood pressure, and use of antihypertensive medications. Conclusion Poor sleep was associated with high hemodynamic stress to the left ventricle in elderly population.