Sleep, carotid intima-media thickness, and arterial stiffness: results from a large longitudinal cohort study

Abstract

Background: To evaluate the associations of sleep health with carotid intima-media thickness (CIMT) and arterial stiffness.

Methods: A total of 41 465 UK Biobank participants were included. Sleep traits were assessed at baseline via self-reported questionnaires, and a composite sleep score was constructed based on six factors: sleep duration, snoring, insomnia, chronotype, daytime napping, and daytime sleepiness, with higher scores indicating poorer sleep health. CIMT and arterial stiffness were measured at follow-up. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between sleep score and study outcomes, adjusting for baseline demographics, socioeconomic status, physical measurements, and medication use.

Results: The mean age of the study population was 55.08 years (SD = 7.57), with 52.91% females and 96.99% Whites. Compared with those for participants with a sleep score of 0, the multivariate-adjusted ORs (95% CI) for those with sleep scores of 1, 2, 3, 4, and 5-6 were 1.04 (0.93, 1.16), 1.09 (0.98, 1.21), 1.17 (1.05, 1.30), 1.15 (1.02, 1.29), and 1.18 (1.03, 1.35) for CIMT thickening, respectively, and 1.04 (0.92, 1.18), 1.13 (1.00, 1.27), 1.25 (1.08, 1.40), 1.23 (1.08, 1.40), and 1.31 (1.12, 1.53) for arterial stiffness, respectively. Poor sleep health was associated with an increased risk of CIMT thickening within all genetic risk categories, and no interaction between the sleep and genetic risk scores was found.

Conclusion: This study highlighted the importance of healthy sleep behaviors in slowing the progression of subclinical cardiovascular disease, regardless of individual's genetic risk status.

Keywords: arterial stiffness; cardiovascular disease; carotid intima-media thickness; genetic risk; sleep.