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    Association of Sleep Duration and Quality With Subclinical Atherosclerosis. Domínguez Fernando,Fuster Valentín,Fernández-Alvira Juan Miguel,Fernández-Friera Leticia,López-Melgar Beatriz,Blanco-Rojo Ruth,Fernández-Ortiz Antonio,García-Pavía Pablo,Sanz Javier,Mendiguren José M,Ibañez Borja,Bueno Héctor,Lara-Pezzi Enrique,Ordovás José M Journal of the American College of Cardiology BACKGROUND:Sleep duration and quality have been associated with increased cardiovascular risk. However, large studies linking objectively measured sleep and subclinical atherosclerosis assessed in multiple vascular sites are lacking. OBJECTIVES:The purpose of this study was to evaluate the association of actigraphy-measured sleep parameters with subclinical atherosclerosis in an asymptomatic middle-aged population, and investigate interactions among sleep, conventional risk factors, psychosocial factors, dietary habits, and inflammation. METHODS:Seven-day actigraphic recording was performed in 3,974 participants (age 45.8 ± 4.3 years; 62.6% men) from the PESA (Progression of Early Subclinical Atherosclerosis) study. Four groups were defined: very short sleep duration <6 h, short sleep duration 6 to 7 h, reference sleep duration 7 to 8 h, and long sleep duration >8 h. Sleep fragmentation index was defined as the sum of the movement index and fragmentation index. Carotid and femoral 3-dimensional vascular ultrasound and cardiac computed tomography were performed to quantify noncoronary atherosclerosis and coronary calcification. RESULTS:When adjusted for conventional risk factors, very short sleep duration was independently associated with a higher atherosclerotic burden with 3-dimensional vascular ultrasound compared to the reference group (odds ratio: 1.27; 95% confidence interval: 1.06 to 1.52; p = 0.008). Participants within the highest quintile of sleep fragmentation presented a higher prevalence of multiple affected noncoronary territories (odds ratio: 1.34; 95% confidence interval: 1.09 to 1.64; p = 0.006). No differences were observed regarding coronary artery calcification score in the different sleep groups. CONCLUSIONS:Lower sleeping times and fragmented sleep are independently associated with an increased risk of subclinical multiterritory atherosclerosis. These results highlight the importance of healthy sleep habits for the prevention of cardiovascular disease. 10.1016/j.jacc.2018.10.060
    Short Sleep Duration by Occupation Group - 29 States, 2013-2014. Shockey Taylor M,Wheaton Anne G MMWR. Morbidity and mortality weekly report The American Academy of Sleep Medicine and the Sleep Research Society have determined that adults require ≥7 hours of sleep per day to promote optimal health (1). Short sleep duration (<7 hours per day) has been linked to adverse health outcomes including cardiovascular disease, obesity, diabetes, depression, and anxiety, as well as safety issues related to drowsy driving and injuries (1,2). Additional research has found that sleep duration varies by characteristics such as race, education, marital status, obesity, and cigarette smoking (3). Work-related factors such as job stress, work hours, shift work, and physically demanding work have been found to be associated with sleep duration and quality (4-6). All of these work factors vary by industry and occupation of employment, and the prevalence of short sleep duration has been shown to vary by broad industry and occupation category (7). To provide updated and more detailed information about which occupation groups have the highest prevalences of short sleep duration, CDC analyzed data from currently employed adults surveyed for the 2013 and 2014 Behavioral Risk Factor Surveillance System (BRFSS) in 29 states. Among 22 major occupation groups, the highest prevalences of short sleep duration were among workers in the following five groups: Production (42.9%), Healthcare Support (40.1%), Healthcare Practitioners and Technical (40.0%), Food Preparation and Serving-Related (39.8%), and Protective Service (39.2%). The significant differences among occupation groups in the prevalence of short sleep duration suggest that work-related factors should be further evaluated as they might relate to sleep. 10.15585/mmwr.mm6608a2
    Association of estimated sleep duration and naps with mortality and cardiovascular events: a study of 116 632 people from 21 countries. Wang Chuangshi,Bangdiwala Shrikant I,Rangarajan Sumathy,Lear Scott A,AlHabib Khalid F,Mohan Viswanathan,Teo Koon,Poirier Paul,Tse Lap Ah,Liu Zhiguang,Rosengren Annika,Kumar Rajesh,Lopez-Jaramillo Patricio,Yusoff Khalid,Monsef Nahed,Krishnapillai Vijayakumar,Ismail Noorhassim,Seron Pamela,Dans Antonio L,Kruger Lanthé,Yeates Karen,Leach Lloyd,Yusuf Rita,Orlandini Andres,Wolyniec Maria,Bahonar Ahmad,Mohan Indu,Khatib Rasha,Temizhan Ahmet,Li Wei,Yusuf Salim European heart journal AIMS:To investigate the association of estimated total daily sleep duration and daytime nap duration with deaths and major cardiovascular events. METHODS AND RESULTS:We estimated the durations of total daily sleep and daytime naps based on the amount of time in bed and self-reported napping time and examined the associations between them and the composite outcome of deaths and major cardiovascular events in 116 632 participants from seven regions. After a median follow-up of 7.8 years, we recorded 4381 deaths and 4365 major cardiovascular events. It showed both shorter (≤6 h/day) and longer (>8 h/day) estimated total sleep durations were associated with an increased risk of the composite outcome when adjusted for age and sex. After adjustment for demographic characteristics, lifestyle behaviours and health status, a J-shaped association was observed. Compared with sleeping 6-8 h/day, those who slept ≤6 h/day had a non-significant trend for increased risk of the composite outcome [hazard ratio (HR), 1.09; 95% confidence interval, 0.99-1.20]. As estimated sleep duration increased, we also noticed a significant trend for a greater risk of the composite outcome [HR of 1.05 (0.99-1.12), 1.17 (1.09-1.25), and 1.41 (1.30-1.53) for 8-9 h/day, 9-10 h/day, and >10 h/day, Ptrend < 0.0001, respectively]. The results were similar for each of all-cause mortality and major cardiovascular events. Daytime nap duration was associated with an increased risk of the composite events in those with over 6 h of nocturnal sleep duration, but not in shorter nocturnal sleepers (≤6 h). CONCLUSION:Estimated total sleep duration of 6-8 h per day is associated with the lowest risk of deaths and major cardiovascular events. Daytime napping is associated with increased risks of major cardiovascular events and deaths in those with >6 h of nighttime sleep but not in those sleeping ≤6 h/night. 10.1093/eurheartj/ehy695
    Sleep duration, cognitive decline, and dementia risk in older women. Chen Jiu-Chiuan,Espeland Mark A,Brunner Robert L,Lovato Laura C,Wallace Robert B,Leng Xiaoyan,Phillips Lawrence S,Robinson Jennifer G,Kotchen Jane M,Johnson Karen C,Manson JoAnn E,Stefanick Marcia L,Sarto Gloria E,Mysiw W Jerry Alzheimer's & dementia : the journal of the Alzheimer's Association INTRODUCTION:Consistent evidence linking habitual sleep duration with risks of mild cognitive impairment (MCI) and dementia is lacking. METHODS:We conducted a prospective study on 7444 community-dwelling women (aged 65-80 y) with self-reported sleep duration, within the Women's Health Initiative Memory Study in 1995-2008. Incident MCI/dementia cases were ascertained by validated protocols. Cox models were used to adjust for multiple sociodemographic and lifestyle factors, depression, cardiovascular disease (CVD), and other clinical characteristics. RESULTS:We found a statistically significant (P = .03) V-shaped association with a higher MCI/dementia risk in women with either short (≤6 hours/night) or long (≥8 hours/night) sleep duration (vs. 7 hours/night). The multicovariate-adjusted hazard for MCI/dementia was increased by 36% in short sleepers irrespective of CVD, and by 35% in long sleepers without CVD. A similar V-shaped association was found with cognitive decline. DISCUSSION:In older women, habitual sleep duration predicts the future risk for cognitive impairments including dementia, independent of vascular risk factors. 10.1016/j.jalz.2015.03.004