0095 Fat Intake Modifies the Association Between Sleep Depth and Cardiac Autonomic Modulation in Adolescents

Abstract Introduction Prior data shows an association between the odds ratio product (ORP), a continuous EEG measure of sleep depth, with heart rate variability (HRV), a continuous EKG measure of cardiac autonomic modulation. Nutritional lifestyle choices can impact cardiac health, with densely-caloric diets or those with greater percentage of specific macronutrients being associated with adverse cardiac outcomes. Adolescence, a developmental period marked by physical changes, is also marked by changes in sleep depth and dietary intake. We examined whether the association between ORP and HRV is more adverse in adolescents with inadequate nutritional intake. Methods We studied 293 adolescents (median 16y) from the Penn State Child Cohort. We extracted ORP during NREM sleep from 9-hour, in-lab polysomnography (PSG), and low-frequency (LF), high-frequency (HF) and time-domain e.g., root mean square standard deviation (RMSSD) HRV indices from 24-h Holter EKG monitoring immediately following PSG. Linear regression analyses examined the association between ORP, and its interaction with nutritional intake (total-calories, protein, total-fat, and carbohydrates), with 24-h HRV indices while adjusting for sex, age, race/ethnicity, obesity, metabolic syndrome, PSG-measured sleep apnea, insomnia symptoms, and actigraphy-measured sleep duration. Results The interactions between ORP and total-fat intake on LF, HF and RMSSD were statistically significant (p 0.05), while the interactions between ORP and total-calories (p 0.10), proteins (p 0.10) or carbohydrates (p0.10) on HRV indices were not statistically significant. Among adolescents with high total-fat intake (≥ 60 gm; n=161), each standard deviation increase in ORP was associated with a -0.1 (0.04) log-Hz, -0.2 (0.07) log-Hz, and -4.3 (1.8) ms decrease in LF (p 0.001), HF (p=0.009) and RMSSD (p=0.02), respectively, while this association was not significant among adolescents with low total-fat intake ( 60 gm; n=162; β=-0.01, SE=0.04, p=0.846; β=0.1, SE=0.07, p=0.348; and β=1.7, SE=2.1, p=0.403, respectively). Conclusion Adolescents who follow high-fat diets are more vulnerable to the impact of shallow sleep on impaired cardiac autonomic balance, making them a targeted group for preventative sleep and cardiovascular strategies. Support (if any) R01HL136587, R01MH118308, UL1TR000127