Relationship of sleep duration with incident cardiovascular outcomes: a prospective study of 33,883 adults in a general population

Abstract

Background Studies on the effect of sleep duration on cardiovascular health have contradictory findings. Underlying health issues may have led to inconsistent results and warrant consideration. We aim to assess the relationship of night sleep duration with incident cardiovascular disease (CVD) in a general population, taking into consideration underlying chronic diseases. Methods Data from Shanghai Suburban Adult Cohort and Biobank with a median follow-up of 5.1 years was used, including 33,883 adults aged 20–74 years old. Incident CVD cases were reported and recorded by the Center for Disease Prevention and Control in Songjiang, Shanghai. We used Cox proportional hazard regression models and restricted cubic spline (RCS) analysis to explore the relationship between different sleep groups and sleep duration with incident CVD outcomes, through stratification by gender and age, as well as different health conditions, with adjustments for potential confounders. Results Long sleep duration (> 9 h) compared to > 7 to ≤ 8 h was associated with overall incident CVD in participants aged ≥ 50 years old: HR(95%CI) = 2.07 (1.15, 3.74) for 50-59y and 1.43 (1.04, 1.93) for 60-74y. RCS analysis showed a J-shaped relationship between sleep and CVD risk in those ≥ 50y, which was confirmed only in those with a chronic health condition. Non-linear relationships between sleep and CVD risk factors, such as BMI, blood glucose and glycated haemoglobin, were observed. Conclusions Long sleep duration is associated with increased risk of CVD in people ≥ 50y. However, CVD risk factors and underlying health conditions such as hypertension, and diabetes, may play a driving role in the relationship.

A Large-Scale Genome-Wide Study of Gene-Sleep Duration Interactions for Blood Pressure in 811,405 Individuals from Diverse Populations

“…We report novel discovery of 22 gene-sleep duration interaction loci for BP traits -12 for short sleep, and 10 for long sleep. Several of the identified variants are rare with allele frequency <=1%, with four variants identified in sex-stratified metaanalyses, and 18 variants specific to either the AFR(1), EUR (6), or HIS (11) population groups. In line with our previous research, the identified genomic loci exhibiting interactions with short and long sleep are non-overlapping (with non-significance in the opposing sleep duration exposure), suggesting distinct mechanisms influencing cardiovascular health.…”

“…The role of long sleep is more elusive, with recent work highlighting the pertinence of inflammatory markers, underlying comorbidity burden (i.e. dyslipidemia, depression) and arterial stiffness metrics 5,6 . This incomplete understanding of the intersection between habitual sleep duration and cardiovascular health necessitates further investigation.…”

Personal Strategies to Reduce the Cardiovascular Impacts of Environmental Exposures

“…99 Poor sleep quality and quantity are both known to increase the risk of incident CVD. [100][101][102][103] Therefore, special attention should be paid to noise reduction during sleep. Personal measures to reduce the effect of noise during sleep have mainly been studied in the hospital setting.…”

Non-Conventional Risk Factors: “Fact” or “Fake” in Cardiovascular Disease Prevention?

“…The most dated studies do not support this correlation [ 226 ]. However, recent evidence suggest a link between sleep duration and CVD development and outcome [ 227 , 228 , 229 , 230 ].…”