Sleep Duration, Sleep Quality, and Markers of Subclinical Arterial Disease in Healthy Men and Women

Chan-Won Kim; Yoosoo Chang; Di Zhao; Miguel Cainzos-Achirica; Seungho Ryu; Hyun-Suk Jung; Kyung Eun Yun; Yuni Choi; Jiin Ahn; Yiyi Zhang; Sanjay Rampal; Youngji Baek; Joao A Lima; Hocheol Shin; Eliseo Guallar; Juhee Cho; Eunju Sung

doi:10.1161/ATVBAHA.115.306110

Sleep Duration, Sleep Quality, and Markers of Subclinical Arterial Disease in Healthy Men and Women

Arterioscler Thromb Vasc Biol. 2015 Oct;35(10):2238-45. doi: 10.1161/ATVBAHA.115.306110. Epub 2015 Sep 10.

Authors

Chan-Won Kim¹, Yoosoo Chang¹, Di Zhao¹, Miguel Cainzos-Achirica¹, Seungho Ryu¹, Hyun-Suk Jung¹, Kyung Eun Yun¹, Yuni Choi¹, Jiin Ahn¹, Yiyi Zhang¹, Sanjay Rampal¹, Youngji Baek¹, Joao A Lima¹, Hocheol Shin¹, Eliseo Guallar¹, Juhee Cho², Eunju Sung²

Affiliations

¹ From the Center for Cohort Studies, Total Healthcare Center (C.-W.K., Y. Chang, S. Ryu, H.-S.J., K.E.Y., Y. Choi, J.A., Y.B., J.C.) and Department of Occupational and Environmental Medicine (Y.C., S. Ryu), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Departments of Epidemiology (D.Z., M.C.-A., Y.Z., S. Rampal, E.G., J.C.) and Medicine (E.G.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; Department of Cardiology, Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins Medical Institutions, Baltimore, MD (M.C.-A.); Department of Social and Preventive Medicine, Julius Centre University of Malaya, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia (S. Rampal); Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (J.A.L.); Department of Family Medicine, Kangbuk Samsung Hospital and Sungkyunkwan University School of Medicine, Seoul, South Korea (H.S., E.S.); Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea (Y. Chang, S. Ryu, J.C.); and Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (J.C.).
² From the Center for Cohort Studies, Total Healthcare Center (C.-W.K., Y. Chang, S. Ryu, H.-S.J., K.E.Y., Y. Choi, J.A., Y.B., J.C.) and Department of Occupational and Environmental Medicine (Y.C., S. Ryu), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Departments of Epidemiology (D.Z., M.C.-A., Y.Z., S. Rampal, E.G., J.C.) and Medicine (E.G.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; Department of Cardiology, Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins Medical Institutions, Baltimore, MD (M.C.-A.); Department of Social and Preventive Medicine, Julius Centre University of Malaya, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia (S. Rampal); Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (J.A.L.); Department of Family Medicine, Kangbuk Samsung Hospital and Sungkyunkwan University School of Medicine, Seoul, South Korea (H.S., E.S.); Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea (Y. Chang, S. Ryu, J.C.); and Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (J.C.). eju.sung@samsung.com jcho@skku.edu.

PMID: 26359509
DOI: 10.1161/ATVBAHA.115.306110

Abstract

Objective: Short and long sleep duration are associated with increased risk of clinical cardiovascular events, but the association between sleep duration and subclinical cardiovascular disease is not well established. We examined the association between sleep duration and sleep quality with coronary artery calcification (CAC) and with brachial-ankle pulse wave velocity (PWV) in a large sample of young and middle-aged asymptomatic adults.

Approach and results: We conducted a cross-sectional study of adult men and women who underwent a health checkup examination, including assessment of sleep duration and quality and coupled with either CAC (n=29 203) or brachial-ankle PWV (n=18 106). The multivariate-adjusted CAC score ratios (95% confidence interval) comparing sleep durations of ≤5, 6, 8, and ≥9 hours with 7 hours of sleep were 1.50 (1.17-1.93), 1.34 (1.10-1.63), 1.37 (0.99-1.89), and 1.72 (0.90-3.28), respectively (P for quadratic trend=0.002). The corresponding average differences in brachial-ankle PWV were 6.7 (0.75-12.6), 2.9 (-1.7 to 7.4), 10.5 (4.5-16.5), and 9.6 (-0.7 to 19.8) cm/s, respectively (P for quadratic trend=0.019). Poor subjective sleep quality was associated with CAC in women but not in men, whereas the association between poor subjective sleep quality and brachial-ankle PWV was stronger in men than in women.

Conclusions: In this large study of apparently healthy men and women, extreme sleep duration and poor subjective sleep quality were associated with increased prevalence of CAC and higher PWV. Our results underscore the importance of an adequate quantity and quality of sleep to maintain cardiovascular health.

Keywords: coronary calcification; pulse wave velocity; sleep duration; sleep quality; subclinical atherosclerosis.

Publication types

Comparative Study

MeSH terms

Adult
Ankle Brachial Index
Calcinosis / physiopathology*
Coronary Artery Disease / physiopathology*
Cross-Sectional Studies
Female
Humans
Male
Multivariate Analysis
Pulsatile Flow / physiology
Pulse Wave Analysis
Reference Values
Severity of Illness Index
Sleep / physiology*
Time Factors
Vascular Stiffness / physiology*