Persistently short sleep duration was associated with a 30% increased risk of cardiovascular disease compared to a steady high sleep trajectory (HR 1.30; 95% CI 1.07-1.58; p=0.010).
Cohort (n=5,602)
Do inverted U-shaped and steady low sleep duration trajectories increase the risk of cardiovascular disease in a general population cohort?
Inverted U-shaped and steady low sleep trajectories are associated with increased cardiovascular risk, partially mediated by subsequent hypertension.
Hazard Ratio: 1.3 (95% CI 1.07–1.58)
p-value: p=0.010
BACKGROUND Prior research has rarely explored the link between sleep duration trajectories and cardiovascular disease (CVD), either in cross-sectional or longitudinal data. We aimed to analyze the relationship between sleep duration trajectories and the incidence of CVD. OBJECTIVE We aimed to analyze the relationship between sleep duration trajectories and the incidence of CVD. METHODS Data from 5,602 participants in the China Health and Retirement Longitudinal Study (CHARLS) were used in the analysis. Sleep duration was self-reported at multiple time points, and group-based trajectory modeling identified distinct patterns of total and nocturnal sleep duration over time. To investigate the link between sleep duration trajectories and CVD, Cox proportional hazards models, restricted cubic splines, and mediation analyses were employed, with sensitivity analyses ensuring the results' robustness. RESULTS Four sleep duration trajectories were identified: steady high, inverted U-shaped, steady low, and U-shaped. Compared to the steady high group, those with an inverted U-shaped pattern had a 29% higher risk of hypertension (total sleep: adjusted HR=1.29, 95%CI: 1.04-1.61, p=0.020; nocturnal sleep: HR=1.29, 95%CI: 1.04-1.59, p=0.018). Persistently short sleepers showed a 30-34% increased risk of CVD (total sleep: HR=1.30, 95%CI: 1.07-1.58, p=0.010; nocturnal sleep: HR=1.34, 95%CI: 1.10-1.64, p=0.003). Notably, steady low sleepers showed a 97% increased stroke risk during nocturnal periods compared to the steady high group (HR=1.97, 95%CI 1.25-3.10, p=0.004). Mediation analysis demonstrated that hypertension served as a partial mediator in the association between sleep instability and stroke risk. CONCLUSIONS Findings identify inverted U-shaped and steady low sleep trajectories as cardiovascular risk factors, with partial mediation by hypertension, suggesting sleep pattern stability as a preventive strategy.
Haixia Fan (Thu,) conducted a cohort in Cardiovascular disease (n=5,602). Persistently short sleep duration (steady low trajectory) vs. Steady high sleep duration trajectory was evaluated on Incidence of cardiovascular disease (HR 1.30, 95% CI 1.07-1.58, p=0.010). Persistently short sleep duration was associated with a 30% increased risk of cardiovascular disease compared to a steady high sleep trajectory (HR 1.30; 95% CI 1.07-1.58; p=0.010).