Age-adjusted cardiovascular mortality with contributory sleep disorders increased significantly in U.S. adults from 1999 to 2020, with the most recent acceleration showing an APC of 11.54% (P<0.000001).
Observational (n=118,440)
Cardiovascular mortality with contributory sleep disorders has risen significantly in the U.S. over two decades, highlighting the critical need to integrate sleep health into cardiovascular risk reduction strategies.
Effect estimate: APC 11.54% (95% CI 7.01-14.12)
p-value: p=<0.000001
Abstract Background Sleep disorders are increasingly recognized as important risk factors for cardiovascular disease (CVD), yet their contribution to cardiovascular mortality remains insufficiently examined at the population level. This study aimed to evaluate long-term trends in CVD mortality where sleep disorders were identified as contributing causes of death. Methods We analyzed U.S. national mortality data from 1999 to 2020 among individuals aged 15 to 84 years. Cases were selected where CVD (ICD-10: I11.0, I11.9, I20-I25, I48, I49.0, I49.9, I50.0, I50.1, I50.9) was the underlying cause and sleep disorders (ICD-10: G47.0-G47.3) were listed as contributing causes. Joinpoint regression was employed to assess temporal changes in age-adjusted mortality rates (AARs), with standard errors provided in the input data and model selection performed using Weighted BIC. APCs were estimated using the Empirical Quantile Method with 5001 resamples. Results A total of 118,440 deaths were included across 22 annual time points. Joinpoint regression identified two significant inflection points (2005 and 2018). From 1999 to 2005, AARs increased sharply (APC = 14.47%; 95% CI: 11.56-19.54; p = 0.0016), followed by a slower rise from 2005 to 2018 (APC = 6.62%; 95% CI: 4.23-10.83; p 0.000001), and a renewed acceleration from 2018 to 2020 (APC = 11.54%; 95% CI: 7.01-14.12; p 0.000001). Males had more than twice the AAR compared to females (3.00 vs. 1.31 per 100,000). Black individuals had the highest burden by race (AAR = 2.55), and geographic variation ranged widely from 0.70 in New York to 3.38 in Wyoming. Conclusions Over two decades, cardiovascular mortality with contributory sleep disorders has risen significantly, with widening demographic and geographic disparities. These findings reinforce that sleep disorders are not merely comorbidities but pivotal, modifiable drivers of cardiovascular morbidity and mortality. Untreated sleep conditions such as insomnia, obstructive sleep apnea, and circadian disruptions exacerbate autonomic dysfunction, inflammation, hypertension, and metabolic dysregulation. Addressing sleep health must become a core component of cardiovascular risk reduction strategies, both in clinical practice and public health policy. Failure to integrate sleep disorder screening, diagnosis, and management into CVD care pathways risks perpetuating a preventable and growing burden of disease. This abstract is funded by: None
Sharma et al. (Fri,) conducted a observational in Cardiovascular disease with contributory sleep disorders (n=118,440). Age-adjusted cardiovascular mortality with contributory sleep disorders increased significantly in U.S. adults from 1999 to 2020, with the most recent acceleration showing an APC of 11.54% (P<0.000001).
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