Abstract MP081: Association between Sleep Characteristics and Cardiovascular Disease Risk Factors in a Population Sample: Chicago Area Sleep Study
Introduction: Shortened sleep duration and poor quality sleep are each associated with cardiovascular disease (CVD) risk factors (e.g., hypertension, obesity, diabetes) in prior cross-sectional and longitudinal studies. However, prior studies have often relied on self-reports of sleep duration, which commonly overestimate actual sleep time. Despite known associations of sleep disordered breathing (e.g., obstructive sleep apnea [OSA]) with CVD, prior studies have not excluded people with sleep disorders before testing these associations.
Objective: We tested whether sleep duration and quality, measured objectively using wrist actigraphy, was associated with fasting glucose, blood pressure, and anthropometric characteristics in adults without a history of OSA and with apnea hypopnea index (AHI)<15 based on one night using in-home apnea detection equipment.
Methods:The Chicago Area Sleep Study (CASS) recruited 531 participants (56% female) ages 35-64 years (mean= 47.5) via commercially available telephone listings. Participants underwent 1 night of screening using in-home apnea detection equipment (ApneaLinkTM) and 411 had AHI<15. Participants wore wrist actigraphs for 7 days (ActiwatchTM) to determine sleep duration, sleep % (% of time during the sleep interval spent sleeping), and minutes of wake after sleep onset (WASO). The Epworth Sleepiness Scale (ESS) was used to determine daytime sleepiness. Height, weight and waist circumference were measured, hypertension and diabetes were determined according to JNC-VII and American Diabetes Association 2010 criteria, respectively.
Results: On average, participants slept for 7 hours (SD=1.2), sleep percentage was 83.2% (SD=20.1), WASO was 41.2 min (SD=21), the ESS score was 6.8 (SD=4.1) and 44% of the sample slept for <7 hours/night. SBP and DBP were 114.5 (SD=13.6) and 70.9 mmHg (SD=9.8), respectively, fasting blood glucose was 92.5 mg/dL (SD=19.6), BMI was 26.2 kg/m2 (SD=4.5) and waist circumference was 87.4 cm (SD=12.7). The prevalence of obesity (BMI>30), hypertension and diabetes was 21%, 14% and 6.1%, respectively. Sleep duration was the only measure to demonstrate statistically significant (p<0.05) associations with metabolic markers, namely inverse associations with SBP, DBP, BMI, waist circumference and the odds of obesity. Following adjustment for age, race, sex, education, physical activity, depressive symptoms, alcohol intake, smoking and sugared beverage intake, sleep duration (<7 hrs. vs. >7hrs) only remained significantly associated with BMI (β= -1.1 kg/m2, SE=0.42) and waist circumference (β= -3.8 cm, SE=1.2).
Conclusions: Sleep duration is associated with CVD risk factors in adults with a low likelihood of OSA. The presence of other adverse health behaviors accounts for much of the observed association.
- © 2012 by American Heart Association, Inc.