Habitual Sleep Duration and Insomnia and the Risk of Cardiovascular Events and All-cause Death: Report from a Community-Based Cohort

Chien, Kuo‐Liong; Chen, Pei-Chung; Hsu, Hsiu-Ching; Su, Ta‐Chen; Sung, Fung‐Chang; Chen, Ming-Fong; Lee, Yuan‐Teh

doi:10.1093/sleep/33.2.177

Cited by 299 publications

(228 citation statements)

References 42 publications

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“…Spline analysis using linear models did not shown any difference in events with shorter duration than 7 hours for both cardiovascular mortality (8 studies)11, 25, 44, 47, 49, 71, 87, 88 and CVD (7 studies) 8, 12, 22, 33, 38, 42, 74. However, longer self‐reported sleep duration >7 hours appeared to be associated with a moderate increase in greater stroke mortality (cubic model shown in Data S8).…”

Section: Resultsmentioning

confidence: 99%

“…A total of 74 studies met the inclusion criteria; the process of study selection is shown in Figure 1 8, 9, 11, 12, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89,...…”

Section: Resultsmentioning

confidence: 99%

“…There were 16 studies‡ (Data S15) that evaluated CVD mortality and 8 studies8, 12, 22, 28, 33, 38, 42, 74 (Data S16) that evaluated CVD events. The J‐shaped pattern was observed for self‐reported sleep duration and CVD mortality, but this was not the case for CVD events, but there were fewer studies in the event analysis.…”

Section: Resultsmentioning

confidence: 99%

“…** References 11, 21, 23, 25, 26, 27, 29, 32, 33, 34, 36, 39, 40, 41, 44, 46, 47, 48, 49, 51, 52, 53, 54, 56, 57, 61, 64, 66, 68, 70, 71, 72, 77, 79, 80, 84, 86, 87, 88.…”

Section: Notesmentioning

confidence: 99%

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

Kwok

Kontopantelis

Kuligowski

et al. 2018

JAHA

331

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: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…** References 11, 21, 23, 25, 26, 27, 29, 32, 33, 34, 36, 39, 40, 41, 44, 46, 47, 48, 49, 51, 52, 53, 54, 56, 57, 61, 64, 66, 68, 70, 71, 72, 77, 79, 80, 84, 86, 87, 88.…”

Section: Notesmentioning

confidence: 99%

See 2 more Smart Citations

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

Kwok

Kontopantelis

Kuligowski

et al. 2018

JAHA

331

227

View full text Add to dashboard Cite

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“…Inadequate sleep is common, with 28% of the US adult population reporting ≤6 hours of sleep per night and with that, a corresponding 24% increased risk of cardiovascular disease 1, 2, 3, 4, 5, 6, 7. Women adopt such behavior in disproportionately greater numbers in part because of lifelong demands on them as caregivers, first to their children and later to ailing and/or elderly family members 8, 9.…”

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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Sleep and Cardiovascular Disease

Gupta

Arnedt

2011

Psychiatry and Heart Disease

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Habitual Sleep Duration and Insomnia and the Risk of Cardiovascular Events and All-cause Death: Report from a Community-Based Cohort

Abstract: Sleep duration and insomnia severity were associated with all-cause death and CVD events among ethnic Chinese in Taiwan. Our data indicate that an optimal sleep duration (7-8 h) predicted fewer deaths.

Cited by 299 publications

References 42 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

Sleep and Cardiovascular Disease

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