Cardiovascular health and sleep disturbances in two population-based cohort studies

• Published in: Heart (British Cardiac Society) Vol. 105; no. 19; pp. 1500 - 1506
• Main Authors: Hausler, Nadine, Lisan, Quentin, Van Sloten, Thomas, Haba-Rubio, Jose, Perier, Marie-Cécile, Thomas, Frédérique, Danchin, Nicolas, Guibout, Catherine, Boutouyrie, Pierre, Heinzer, Raphael, Jouven, Xavier, Marques-Vidal, Pedro, Empana, Jean-Philippe
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd and British Cardiovascular Society 01.10.2019; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Body mass index; Cardiac risk factors and prevention; Cohort analysis; epidemiology; Health risk assessment; Life Sciences; Population-based studies; Sleep deprivation; Studies; Womens health; France; cardiac risk factors and prevention; epidemiology
• ISSN: 1355-6037; 1468-201X; 1468-201X
• DOI: 10.1136/heartjnl-2018-314485

ObjectiveWe aimed to investigate the association between cardiovascular health (CVH), as defined by the American Heart Association, and several sleep disturbances.MethodsTwo community-based cohorts, the Paris Prospective Study 3 (PPS3, France, n=6441) and the CoLaus study (Switzerland, n=2989) were analysed. CVH includes 7 metrics which all can be classified as poor, intermediate and ideal. Global CVH score was categorised into poor (0–2 ideal metrics), intermediate (3–4 ideal metrics) and ideal (≥5 ideal metrics). Associations between global CVH and self-reported sleep disturbances (proxy of sleep-disordered breathing [SDB], excessive daytime sleepiness, insomnia symptoms and short/long sleep duration) and SDB severity measured by polysomnography (PSG) were investigated. Adjusted OR/relative risk ratio (RRR) and 95% CIs were estimated. Subjects with previous cardiovascular disease were excluded.ResultsCompared with poor CVH, subjects with intermediate and ideal global CVH had lower odds of self-reported SDB in both cohorts (ORs 0.55; 95% CI 0.44 to 0.68 and 0.35; 95% CI 0.22 to 0.53, respectively) and had lower SDB severity measured by PSG (RRR 0.07; 95% CI 0.02 to 0.20) in CoLaus. Subjects with intermediate and ideal global CVH had lower odds of excessive daytime sleepiness in PPS3 (ORs 0.82; 0.72 to 0.95 and 0.80; 0.82 to 1.02, respectively). No consistent associations were found between CVH and sleep duration or insomnia symptoms.ConclusionsHigher levels of CVH are associated with lower odds of SDB and excessive daytime sleepiness. However, causal interpretation cannot be made and associations might be bidirectional.