BACKGROUND AND PURPOSE:

• Fernandez-Mendoza et al. (Journal of the American Heart Association, 2019) investigated whether objective short sleep duration increased the risk of mortality in individuals with diabetes, hypertension, heart disease and stroke

METHODS:

• Longitudinal, population-based cohort study
  • Data derived from the Penn State Adult Cohort
• Participants and Study Design
  • Adults, 20 to 74 years
  • Phase 1: Telephone interviews with 16,583 individuals (1990 to 1991)
  • Phase 2: 741 men and 1000 women were randomly selected and studied in the sleep laboratory (1990 to 1999)
  • Cause of death: Data extracted yearly from (2014 to 2017) CDC National Death Index
• Definitions
  • Cardiometabolic risk factors (CMRs) : Stage 2 hypertension and/or type 2 diabetes mellitus
  • Cerebrovascular diseases (CBVD): Diagnosis or treatment for heart disease and/or stroke
  • Objective short sleep duration: Total sleep time <6 hours
• Data analysis
  • Hazard models were used to estimated multivariable-adjusted hazard ratios (HRs) and 95% CIs

RESULTS:

• 1,654 adults were included in the study
  • Mean age 47.5 years | 52.5% women | 89.8% white
• Risk of all-cause mortality associated with CMR or CBVD was significantly higher with <6 hours of sleep (p<0.05)
  • HR 3.17 (95% CI, 2.16 to 4.65)
• <6 hours sleep
  • CMR was associated with a 1.83 higher risk of CBVD mortality (95% CI, 1.07 to 3.13)
  • CBVD was associated with a 2.92 higher risk of cancer mortality (95% CI, 1.28 to 6.65)
• ≥6 hours sleep
  • CMR was not significantly associated with CBVD mortality
    • HR 1.35 (95% CI, 0.70 to 2.63)
  • CBVD was not significantly associated with cancer mortality
    • HR 0.55 (95% CI, 0.18 to 1.64)

CONCLUSION:

• Short sleep duration (<6 hours) in middle-age adults can predict
  • All-cause and cancer specific mortality prognosis among individuals with CMR
• The authors note the following clinical implications

Clinicians should become aware that the risk of all‐cause and cancer mortality associated with hypertension, diabetes mellitus, heart disease, or stroke is greater in patients with objective short sleep duration, a potentially modifiable risk factor

Patients with hypertension, diabetes mellitus, heart disease, or stroke, who sleep objectively short, may benefit from targeted treatments to lengthen sleep and improve their long-term prognosis

Learn More – Primary Sources:

Interplay of Objective Sleep Duration and Cardiovascular and Cerebrovascular Diseases on Cause-Specific Mortality

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