Association Between Sleep Apnea, Sleep Duration, and Serum Lipid Profile in an Urban, Male, Working Population in Japan

Study Questions:

Are sleep characteristics, including apnea and sleep duration, associated with lipids?

Methods:

This cross-sectional study enrolled subjects who were male employees of an urban wholesale company in Japan; all of the male employees were invited to participate in the study between January 2004 and December 2005. Of the 466 male subjects who were invited to participate, those who did not complete the baseline questionnaire and/or the home-based monitoring, had missing lab work. Demographic characteristics, sleep apnea several, or sleep duration did not differ between those included and excluded from this study. Lipid parameters measured included total cholesterol, high-density lipoprotein and low-density lipoprotein (LDL) cholesterol, and triglycerides. Sleep apnea was measured with the respiratory disturbance index. Sleep duration was measured with an actigraph.

Results:

A total of 275 men, all employed in a Japanese company, were included in this study. Thirteen subjects with dyslipidemia (8.8%) were being treated with lipid-lowering drugs, and 143 subjects met Japanese criteria for dyslipidemia. Percent sleep time of oxygen saturation <90% (as measured by pulse oximetry [SpO2]) and prevalence of severe obstructive sleep apnea were greater in subjects with dyslipidemia than in those without. Overall sleep duration and mean SpO2 during sleep were lower in subjects with dyslipidemia than in those without. Univariate analysis showed that the respiratory disturbance index was positively correlated with serum triglyceride levels (p < 0.01), and sleep duration was negatively correlated with serum total cholesterol levels (p = 0.03) and serum LDL cholesterol levels (p = 0.04). Stepwise multiple regression analysis revealed that triglyceride level was correlated with respiratory disturbance index (p = 0.02), body mass index (p = 0.01), and alcohol intake (p = 0.01), and that total cholesterol was correlated with sleep duration (p = 0.03), age (p = 0.02), and waist/hip ratio (p = 0.02).

Conclusions:

The investigators concluded that short sleep duration was associated with total cholesterol levels, and respiratory disturbance index was positively associated with triglyceride levels among working-aged men in an urban Japanese company.

Perspective:

These data add to a growing body of literature which suggests that sleep characteristics are associated with cardiovascular risk. The question remains whether treatment of sleep pathology such as obstructive sleep apnea would result in improvements in lipids, which were independent of changes in lifestyle patterns (e.g., diet and physical activity) and body mass index.

Clinical Topics: Diabetes and Cardiometabolic Disease, Dyslipidemia, Heart Failure and Cardiomyopathies, Prevention, Hypertriglyceridemia, Lipid Metabolism, Nonstatins, Heart Failure and Cardiac Biomarkers, Diet, Sleep Apnea

Keywords: Japan, Life Style, Sleep Apnea Syndromes, Cholesterol, Dyslipidemias, Waist-Hip Ratio, Body Mass Index, Biological Markers, Troponin I, Motor Activity, Cardiovascular Diseases, Diet, Triglycerides, Sleep Apnea, Obstructive


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