Interplay of Objective #sleep Duration and Cardiovascular and #Cerebrovascular Diseases on Cause‐Specific Mortality

Cardiovascular and cerebrovascular diseases (CBVDs) and cancer are leading causes of death. Short sleep is a potential contributor to health; however, its role in predicting mortality associated with cardiometabolic risk factors (CMRs) and CBVD remains poorly understood. 

CMR was defined as stage 2 hypertension and/or type 2 diabetes mellitus on the basis of blood pressure and glucose levels or a report of diagnosis or treatment for these conditions. CBVD was defined as a report of diagnosis or treatment for heart disease and/or stroke

Objective short sleep duration was defined as polysomnographic total sleep time <6 hours. Cox proportional hazard models estimated multivariable‐adjusted hazard ratios (HRs) and 95% CIs.

Risk of all‐cause mortality associated with CMR or CBVD was significantly modified by objective sleep duration (P<0.05), and it was significantly higher in subjects who slept <6 hours (HR, 2.14 [95% CI, 1.52–3.02] and HR, 3.17 [95% CI=2.16–4.65], respectively). In subjects who slept <6 hours, CMR was associated with a 1.83 higher (95% CI, 1.07–3.13) risk of CBVD mortality and CBVD with a 2.92 higher (95% CI, 1.28–6.65) risk of cancer mortality.

In subjects who slept ≥6 hours, CMR was not significantly associated with CBVD mortality (HR, 1.35; 95% CI, 0.70–2.63) nor was CBVD significantly associated with cancer mortality (HR, 0.55; 95% CI, 0.18–1.64).

Conclusions
Objective short sleep duration predicts the all‐cause mortality prognosis of middle‐aged adults with CMR and the cancer‐specific mortality prognosis of those with CBVD.

https://www.ahajournals.org/doi/10.1161/JAHA.119.013043