Abstract P354: Objective Short Sleep Duration Increases the Risk of Mortality Associated with the Metabolic Syndrome
Background: The metabolic syndrome (MetS), the clustering of cardiometabolic risk factors, has been associated with short sleep duration and mortality. Most studies have been limited by using self-report measures and treating sleep duration as a sole, independent predictor, thus, its role in predicting mortality is still not well-established.
Hypothesis: We hypothesized that objective sleep duration is an effect modifier of the impact of the MetS on mortality.
Methods: We addressed this question in the Penn State Adult Cohort, a random, general population sample of 1,741 men and women (48.7 ± 13.5 years) who were studied in the sleep laboratory and followed-up for 16.7 ± 4.6 years. MetS was defined by the presence of three or more of obesity (≥30 m2/kg), elevated total cholesterol (≥200 mg/dL), triglycerides (≥150 mg/dL), fasting glucose (≥100 mg/dL), and blood pressure (≥85/130 mmHg). Polysomnographic (PSG) sleep duration was classified into clinically meaningful categories. Among the 1,741participants, 23.5% (n=478) of them died during the follow-up.
Results: We tested the interaction between MetS and PSG sleep duration on mortality using Cox proportional hazard models controlling for multiple potential confounders (p-value < .05).The hazard ratios (95%CI) of all-cause and cardiovascular / cerebrovascular mortality associated with MetS were 1.28 (0.88-1.86) and 1.49 (0.75-2.97) for individuals who slept ≥ 6 hours and 1.99 (1.53-2.59) and 2.10 (1.39-3.16) for individuals who slept < 6 hours. Interestingly, this effect modification was primarily driven by the elevated blood pressure and glucose dysregulation components of the MetS.
Conclusions: The risk of mortality associated with the MetS increases as a function of short sleep duration. Short sleep in individuals with MetS may be linked to greater central autonomic and metabolic dysfunction. Future clinical trials should examine whether lengthening sleep improves the prognosis of individuals with MetS.
Author Disclosures: J. Fernandez-Mendoza: None. F. He: None. A.N. Vgontzas: None. D. Liao: None. E.O. Bixler: None.
This research has received full or partial funding support from the American Heart Association, National Center.
- © 2017 by American Heart Association, Inc.