Poor self-reported sleep is associated with risk factors for cardiovascular disease: a cross-sectional analysis in half a million adults

Authors: VALENZUELA, PEDRO - Universidad Europea De Madrid; SANTOS-LOZANO, ALEJANDRO - The Miguel De Cervantes European University; TORRES BARRAN, ALBERTO - Institute Of Mathematical Sciences(ICMAT); MORALES, JAVIER - University Of Cadiz; CASTILLO-GARCIA, ADRIAN - Fostering Industrial Symbiosis For A Sustainable Resource Intensive Industry Across The Extended Co; RUILOPE, LUIS - The Research Institute Hospital 12 De Octubre; RIOS-INSUA, DAVID - Institute Of Mathematical Sciences(ICMAT); ORDOVAS, JOSE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; LUCIA, ALEJANDRO - Universidad Europea De Madrid

Submitted to: European Journal of Clinical Investigation
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/25/2021
Publication Date: 12/27/2021
Citation: Valenzuela, P.L., Santos-Lozano, A., Torres Barran, A., Morales, J.S., Castillo-Garcia, A., Ruilope, L.M., Rios-Insua, D., Ordovas, J.M., Lucia, A. 2021. Poor self-reported sleep is associated with risk factors for cardiovascular disease: a cross-sectional analysis in half a million adults. European Journal of Clinical Investigation. e13738. https://doi.org/10.1111/eci.13738.
DOI: https://doi.org/10.1111/eci.13738

Interpretive Summary: Sleep quantity and quality significantly affect cardiovascular disease (CVD) risk. However, little is known about the relationship between poor sleep and other classical CVD risk factors. The objective of this work conducted by investigators in Spain and at the HNRCA in Boston was to assess the association between sleep characteristics and the likelihood of major CVD risk factors. For this purpose, data from 521,364 subjects (32% female, 44+/-9yrs [18-64]) were analyzed. Poor sleep (reported by 33% of participants) was associated with a higher presence of CVD risk factors, particularly physical inactivity. Conversely, participants with adequate sleep had less CVD risk than their peers with general poor sleep. In summary, these data reinforce the relationship between poor sleep and major CVD risk factors. These findings support the importance of monitoring and improving sleep patterns for primary CVD prevention.

Technical Abstract: Background Sleep is known to affect cardiovascular health, but some controversy exists on the independent association between different sleep characteristics (duration, restfulness, difficulties falling asleep) and specific risk factors for cardiovascular disease (CVD). We aimed to assess the association between self-reported sleep characteristics and the likelihood of major CVD risk factors. Methods Totally, 521,364 Spanish workers (32% female, 44 +/- 9 years [18-64]) insured by an occupational risk prevention company participated in this nationwide cross-sectional study. Participants' sleep was considered 'poor' if they reported having >/=1 of the following conditions: excessively short (<6 h/d) or long (>9 h/d) sleep, unrestful sleep, or difficulties to fall asleep. We assessed the independent association between aforementioned sleep characteristics and the prevalence of hypertension, diabetes, hypercholesterolaemia, obesity and physical inactivity. Results Poor sleep (reported by 33% of participants) was associated with a higher likelihood of presenting all CVD risk factors individually, particularly physical inactivity (which prevalence was ~3-fold higher in the poor sleep group compared with participants reporting no sleep abnormality). In separate analyses, all the different sleep characteristics were associated with the likelihood of >=2 CVD risk factors. Participants with optimal sleep, normal sleep duration, no difficulties falling sleep and restful sleep showed a lower total CVD risk score than their peers with poor sleep, short sleep duration, difficulties falling sleep and unrestful sleep, respectively (all p < .001). Conclusions Poor sleep was associated with a higher likelihood of presenting major CVD risk factors. These findings might support the importance of monitoring and improving sleep patterns for primary CVD prevention.