Log in to MyACC
Sleep Irregularity and Risk of Cardiovascular Events
Study Questions:
What is the association between sleep regularity and risk of cardiovascular disease (CVD)?
Methods:
The investigators assessed sleep regularity in 1,992 participants free of CVD in the MESA (Multi-Ethnic Study of Atherosclerosis) study, who completed 7-day wrist actigraphy for sleep assessment from 2010 to 2013 and were prospectively followed through 2016. The study used the SD of actigraphy-measured sleep duration and sleep-onset timing across 7 days. Incident CVD included nonfatal and fatal CV events. A Cox proportional hazards model was used to estimate hazard ratios (HRs) for incident CVD according to SD of sleep duration and timing, adjusted for traditional CVD risk factors (including CVD biomarkers) and other sleep-related factors (including average sleep duration).
Results:
During a median follow-up of 4.9 years, 111 participants developed CVD events. The multivariable-adjusted HRs (95% confidence intervals) for CVD across categories of sleep duration SD were 1.00 (reference) for ≤60 minutes, 1.09 (0.62-1.92) for 61-90 minutes, 1.59 (0.91-2.76) for 91-120 minutes, and 2.14 (1.24-3.68) for >120 minutes (p trend = 0.002). Similarly, compared with participants with a sleep timing SD ≤30 minutes, the HRs (95% confidence intervals) for CVD were 1.16 (0.64-2.13) for 31-60 minutes, 1.52 (0.81-2.88) for 61-90 minutes, and 2.11 (1.13-3.91) for >90 minutes (p trend = 0.002). Exclusion of current shift workers yielded similar results.
Conclusions:
The authors concluded that irregular sleep duration and timing may be novel risk factors for CVD, independent of traditional CVD risk factors and sleep quantity and/or quality.
Perspective:
This cohort study reports that participants with the most irregular sleep duration or timing had a >2-fold risk of developing CVD over a median follow-up of 4.9 years compared with participants with the most regular sleep patterns. Furthermore, the results remained robust after considering multiple established CVD risk factors and conventional measures of sleep quantity and quality, which suggested that irregular sleep duration and timing might be novel and independent risk factors for CVD. These data suggest the need to evaluate the role of healthy sleep practice interventions as a strategy for additional CV risk reduction.
Clinical Topics: Diabetes and Cardiometabolic Disease, Prevention, Sleep Apnea
Keywords: Actigraphy, Biomarkers, Cardiovascular Diseases, Metabolic Syndrome, Primary Prevention, Risk Factors, Risk Reduction Behavior, Sleep, Sleep Wake Disorders, Sleep Deprivation, Sleep Disorders, Circadian Rhythm
< Back to Listings
