Associations of Framingham risk score profile and coronary artery calcification with sleep characteristics in middle-aged men and women: Pittsburgh SleepSCORE study.

BACKGROUND Short and less efficient sleep may be risk factors for atherosclerosis. Few studies have investigated the associations between sleep characteristics and early cardiovascular disease (CVD) risk. OBJECTIVE Evaluate the associations between coronary artery calcification (CAC) and Framingham risk score profile with sleep characteristics in middle-aged men and women with no history of diagnosed myocardial infarction, interventional cardiology procedures, stroke, diabetes, or sleep disorders. METHOD 224 participants enrolled in an epidemiological study of disparities in CVD risk were recruited for a 9-night assessment of sleep, with 2 nights of polysomnography (PSG) and 9 nights of actigraphy and sleep diaries. Of the 224 participants, 110 had high/moderate Framingham risk scores and 114 had low scores; 195 had computed tomography measures of CAC. RESULTS Individuals who had any CAC or higher Framingham risk scores had elevated apnea/hypopnea index (AHI) values, independent of age, race, and gender. The AHI association with CAC was nonsignificant in analyses adjusting for body mass index (BMI). Those with higher Framingham risk score profiles had shorter PSG sleep duration and less percent stage 3-4 and delta power sleep. High blood pressure and left ventricular hypertrophy were related to AHI and sleep duration, independent of BMI. Neither sleep duration nor efficiency was associated with CAC. CONCLUSIONS CAC was not associated with AHI, independent of BMI in a community-based sample of middle-aged men and women. Framingham risk score profiles were related to poor sleep. Sleep duration may not be related to early plaque burden in relatively healthy individuals.

[1]  Elizabeth J. Mezick,et al.  Are sleep and depression independent or overlapping risk factors for cardiometabolic disease? , 2011, Sleep medicine reviews.

[2]  S. J. Kim,et al.  Association of coronary artery calcification with obstructive sleep apnea and obesity in middle-aged men. , 2010, Nutrition, metabolism, and cardiovascular diseases : NMCD.

[3]  David A Calhoun,et al.  Sleep and hypertension. , 2010, Chest.

[4]  G. Lip,et al.  Obstructive sleep apnea and cardiovascular disease. , 2010, International journal of cardiology.

[5]  Daniel J Buysse,et al.  Intra-individual variability in sleep duration and fragmentation: Associations with stress , 2009, Psychoneuroendocrinology.

[6]  L. Gallicchio,et al.  Sleep duration and mortality: a systematic review and meta‐analysis , 2009, Journal of sleep research.

[7]  J. Floras,et al.  Obstructive sleep apnoea and its cardiovascular consequences , 2009, The Lancet.

[8]  Daniel J Buysse,et al.  Race and financial strain are independent correlates of sleep in midlife women: the SWAN sleep study. , 2009, Sleep.

[9]  S. Sidney,et al.  Short sleep duration and incident coronary artery calcification. , 2008, JAMA.

[10]  M. Marmot,et al.  Correlates of short and long sleep duration: a cross-cultural comparison between the United Kingdom and the United States: the Whitehall II Study and the Western New York Health Study. , 2008, American journal of epidemiology.

[11]  P. Lavie,et al.  Cardiovascular morbidity and mortality in obstructive sleep apnea. , 2008, Current pharmaceutical design.

[12]  Daniel J Buysse,et al.  Blood pressure dipping and sleep disturbance in African-American and Caucasian men and women. , 2008, American journal of hypertension.

[13]  Daniel J Buysse,et al.  Influence of Race and Socioeconomic Status on Sleep: Pittsburgh SleepSCORE Project , 2008, Psychosomatic medicine.

[14]  V. Somers,et al.  Independent association between obstructive sleep apnea and subclinical coronary artery disease. , 2008, Chest.

[15]  R. Bootzin,et al.  Relationship between reported and measured sleep times: the sleep heart health study (SHHS). , 2007, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[16]  C. Meisinger,et al.  Sleep duration and sleep complaints and risk of myocardial infarction in middle-aged men and women from the general population: the MONICA/KORA Augsburg cohort study. , 2007, Sleep.

[17]  D. Mannino,et al.  Do insomnia complaints cause hypertension or cardiovascular disease? , 2007, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[18]  Steven Shea,et al.  Risk Factors for the Progression of Coronary Artery Calcification in Asymptomatic Subjects: Results From the Multi-Ethnic Study of Atherosclerosis (MESA) , 2007, Circulation.

[19]  S. Reis,et al.  Racial differences in coronary artery calcification are not attributed to differences in lipoprotein particle sizes: the Heart Strategies Concentrating on Risk Evaluation (Heart SCORE) Study. , 2006, American heart journal.

[20]  W. T. McNicholas,et al.  Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities , 2006, European Respiratory Journal.

[21]  A. Chesson,et al.  The American Academy of Sleep Medicine (AASM) Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications , 2007 .

[22]  Jose M Marin,et al.  Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study , 2005, The Lancet.

[23]  Jeffrey L. Anderson,et al.  Left ventricular hypertrophy is a common echocardiographic abnormality in severe obstructive sleep apnea and reverses with nasal continuous positive airway pressure. , 2003, Chest.

[24]  Daniel J Buysse,et al.  Healthy Older Adults’ Sleep Predicts All-Cause Mortality at 4 to 19 Years of Follow-Up , 2003, Psychosomatic medicine.

[25]  J. Broman,et al.  Sleep complaints predict coronary artery disease mortality in males: a 12‐year follow‐up study of a middle‐aged Swedish population , 2002, Journal of internal medicine.

[26]  K. Matthews,et al.  Socioeconomic Status as a Correlate of Sleep in African‐American and Caucasian Women , 1999, Annals of the New York Academy of Sciences.

[27]  Daniel J Buysse,et al.  Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. , 1999, Sleep.

[28]  J. Rumberger,et al.  Coronary artery calcium area by electron-beam computed tomography and coronary atherosclerotic plaque area. A histopathologic correlative study. , 1995, Circulation.

[29]  F. Yasuma,et al.  Cardiac hypertrophy in obstructive sleep apnea syndrome. , 1995, Chest.

[30]  K. Anderson,et al.  An updated coronary risk profile. A statement for health professionals. , 1991, Circulation.

[31]  R. Detrano,et al.  Quantification of coronary artery calcium using ultrafast computed tomography. , 1990, Journal of the American College of Cardiology.

[32]  Daniel J Buysse,et al.  The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research , 1989, Psychiatry Research.

[33]  A. Rechtschaffen,et al.  A manual of standardized terminology, technique and scoring system for sleep stages of human subjects , 1968 .

[34]  A. Rechtschaffen A manual of standardized terminology, techniques and scoring system for sleep of human subjects , 1968 .