BACKGROUND: Sleep irregularity has been linked to incident cardiovascular disease. Less is known about associations of sleep regularity with atherosclerosis. We examined cross-sectional associations of actigraphy-assessed sleep duration and sleep timing regularity with subclinical atherosclerosis in the community-based MESA (Multi-Ethnic Study of Atherosclerosis). METHODS AND RESULTS: MESA Sleep Ancillary Study participants (N=2032; mean age, 68.6±9.2 years; 37.9% White) completed 7-day wrist actigraphy. Participants underwent assessments of coronary artery calcium, carotid plaque presence, carotid intima-media thickness, and the ankle-brachial index. Sleep regularity was quantified by the 7-day with-in person SD of sleep duration and sleep onset timing. Relative risk regression models were used to calculate prevalence ratios and 95% CIs. Models are adjusted for demographics, cardiovascular disease risk factors, and other objectively assessed sleep characteristics including obstructive sleep apnea, sleep duration, and sleep fragmentation. After adjustment, compared with participants with more regular sleep durations (SD ≤60 minutes), participants with greater sleep duration irregularity (SD >120 minutes) were more likely to have high coronary artery calcium burden (>300; prevalence ratio, 1.33 [95% CI, 1.03–1.71]) and abnormal ankle-brachial index (<0.9; prevalence ratio, 1.75 [95% CI, 1.03–2.95]). Compared with participants with more regular sleep timing (SD ≤30 minutes), participants with irregular sleep timing (SD >90 minutes) were more likely to have high coronary artery calcium burden (prevalence ratio, 1.39 [95% CI, 1.07–1.82]). Associations persisted after adjustment for cardiovascular disease risk factors and average sleep duration, obstructive sleep apnea, and sleep fragmentation. CONCLUSIONS: Sleep irregularity, particularly sleep duration irregularity, was associated with several measures of subclinical atherosclerosis. Sleep regularity may be a modifiable target for reducing atherosclerosis risk. Future investigation into cardiovascular risk reduction interventions targeting sleep irregularity may be warranted.
|Original language||English (US)|
|Journal||Journal of the American Heart Association|
|State||Published - Feb 21 2023|
Bibliographical noteFunding Information:
This research was supported by National Heart, Lung, and Blood Institute contracts HHSN268201500003I, N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, and N01-HC-95169; and by National Center for Advancing Translational Sciences grants UL1-TR-000040, UL1-TR-001079, and UL1-TR-001420. The MESA Sleep Study was supported by National Heart, Lung, and Blood Institute grant HL56984. Dr Full was partially supported by National Heart, Lung, and Blood Institute training grant T32 HL007779 and Dr Lutsey by K24 HL159246. Dr Redline was partially supported by National Heart, Lung, and Blood Institute R35 HL 1351358181. Dr Huang was supported by K01HL143034. The funders had no role in the conduct of the study; in the collection, analysis, and interpretation of the data; or in the preparation or approval of the manuscript.
© 2023 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
- cardiovascular disease
- circadian rhythms
- risk factors
PubMed: MeSH publication types
- Journal Article