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Published in: Current Cardiology Reports 4/2020

01-04-2020 | Sleep Apnea | Ischemic Heart Disease (D Mukherjee, Section Editor)

Effects of Sleep Duration on Cardiovascular Events

Authors: Adeel Ahmad, S. Claudia Didia

Published in: Current Cardiology Reports | Issue 4/2020

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Abstract

Purpose of Review

Sleep is an essential component of human health, and suboptimal sleep duration has been associated with increased cardiovascular morbidity and mortality. This review summarizes physiological and pathological effects of sleep duration on the cardiovascular system.

Recent Findings

Both decreased and increased duration of sleep lead to increased cardiovascular mortality and has a U-shaped curve. Sleep apnea is an independent risk factor for atherosclerosis and hypertension, and its treatment with continuous positive airway pressure (CPAP) results in increased survival.

Summary

Estimated sleep duration of 6–8 h is associated with decreased mortality and major cardiovascular events and should be addressed by clinicians during routine visits.
Literature
1.
go back to reference Jike M, Itani O, Watanabe N, Buysse DJ, Kaneita Y. Long sleep duration and health outcomes: a systematic review, meta-analysis and meta-regression. Sleep Med Rev. 2018;39:25–36.CrossRefPubMed Jike M, Itani O, Watanabe N, Buysse DJ, Kaneita Y. Long sleep duration and health outcomes: a systematic review, meta-analysis and meta-regression. Sleep Med Rev. 2018;39:25–36.CrossRefPubMed
2.
go back to reference Carskadon MA. Normal Human Sleep: An overview. Philidelphia: Saunders; 2000. Carskadon MA. Normal Human Sleep: An overview. Philidelphia: Saunders; 2000.
4.
go back to reference Consensus Conference P, et al. Joint Consensus statement of the American Academy of Sleep Medicine and Sleep Research Society on the recommended amount of sleep for a healthy adult: methodology and discussion. J Clin Sleep Med. 2015;11(8):931–52.CrossRef Consensus Conference P, et al. Joint Consensus statement of the American Academy of Sleep Medicine and Sleep Research Society on the recommended amount of sleep for a healthy adult: methodology and discussion. J Clin Sleep Med. 2015;11(8):931–52.CrossRef
5.
go back to reference Hirshkowitz M, Whiton K, Albert SM, Alessi C, Bruni O, DonCarlos L, et al. National Sleep Foundation’s updated sleep duration recommendations: final report. Sleep Health. 2015;1(4):233–43.CrossRefPubMed Hirshkowitz M, Whiton K, Albert SM, Alessi C, Bruni O, DonCarlos L, et al. National Sleep Foundation’s updated sleep duration recommendations: final report. Sleep Health. 2015;1(4):233–43.CrossRefPubMed
6.
go back to reference Liu Y, et al. Prevalence of healthy sleep duration among adults--United States, 2014. MMWR Morb Mortal Wkly Rep. 2016;65(6):137–41.CrossRefPubMed Liu Y, et al. Prevalence of healthy sleep duration among adults--United States, 2014. MMWR Morb Mortal Wkly Rep. 2016;65(6):137–41.CrossRefPubMed
7.
go back to reference Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol. 2013;177(9):1006–14.CrossRefPubMedPubMedCentral Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol. 2013;177(9):1006–14.CrossRefPubMedPubMedCentral
9.
go back to reference Li X, Lin L, Lv L, Pang X, du S, Zhang W, et al. U-shaped relationships between sleep duration and metabolic syndrome and metabolic syndrome components in males: a prospective cohort study. Sleep Med. 2015;16(8):949–54.CrossRefPubMed Li X, Lin L, Lv L, Pang X, du S, Zhang W, et al. U-shaped relationships between sleep duration and metabolic syndrome and metabolic syndrome components in males: a prospective cohort study. Sleep Med. 2015;16(8):949–54.CrossRefPubMed
10.
go back to reference Kim JY, Yadav D, Ahn SV, Koh SB, Park JT, Yoon J, et al. A prospective study of total sleep duration and incident metabolic syndrome: the ARIRANG study. Sleep Med. 2015;16(12):1511–5.CrossRefPubMed Kim JY, Yadav D, Ahn SV, Koh SB, Park JT, Yoon J, et al. A prospective study of total sleep duration and incident metabolic syndrome: the ARIRANG study. Sleep Med. 2015;16(12):1511–5.CrossRefPubMed
11.
go back to reference Somers VK, et al. Sympathetic-nerve activity during sleep in normal subjects. N Engl J Med. 1993;328(5):303–7.CrossRefPubMed Somers VK, et al. Sympathetic-nerve activity during sleep in normal subjects. N Engl J Med. 1993;328(5):303–7.CrossRefPubMed
12.
go back to reference Siobhan Banks JD, Basner M, and Dinges DF, Effects of sleep deprivation, in principles and practice of sleep medicine. 2017, Elsevier. Siobhan Banks JD, Basner M, and Dinges DF, Effects of sleep deprivation, in principles and practice of sleep medicine. 2017, Elsevier.
14.
go back to reference Hijmans JG, Levy M, Garcia V, Lincenberg GM, Diehl KJ, Greiner JJ, et al. Insufficient sleep is associated with a pro-atherogenic circulating microRNA signature. Exp Physiol. 2019;104(6):975–82.CrossRefPubMedPubMedCentral Hijmans JG, Levy M, Garcia V, Lincenberg GM, Diehl KJ, Greiner JJ, et al. Insufficient sleep is associated with a pro-atherogenic circulating microRNA signature. Exp Physiol. 2019;104(6):975–82.CrossRefPubMedPubMedCentral
15.
go back to reference Bain AR, Weil BR, Diehl KJ, Greiner JJ, Stauffer BL, DeSouza C. Insufficient sleep is associated with impaired nitric oxide-mediated endothelium-dependent vasodilation. Atherosclerosis. 2017;265:41–6.CrossRefPubMed Bain AR, Weil BR, Diehl KJ, Greiner JJ, Stauffer BL, DeSouza C. Insufficient sleep is associated with impaired nitric oxide-mediated endothelium-dependent vasodilation. Atherosclerosis. 2017;265:41–6.CrossRefPubMed
16.
go back to reference Grandner MA, Sands-Lincoln MR, Pak VM, Garland SN. Sleep duration, cardiovascular disease, and proinflammatory biomarkers. Nat Sci Sleep. 2013;5:93–107.CrossRefPubMedPubMedCentral Grandner MA, Sands-Lincoln MR, Pak VM, Garland SN. Sleep duration, cardiovascular disease, and proinflammatory biomarkers. Nat Sci Sleep. 2013;5:93–107.CrossRefPubMedPubMedCentral
17.
go back to reference Boudjeltia KZ, Faraut B, Esposito MJ, Stenuit P, Dyzma M, Antwerpen PV, et al. Temporal dissociation between myeloperoxidase (MPO)-modified LDL and MPO elevations during chronic sleep restriction and recovery in healthy young men. PLoS One. 2011;6(11):e28230.CrossRefPubMed Boudjeltia KZ, Faraut B, Esposito MJ, Stenuit P, Dyzma M, Antwerpen PV, et al. Temporal dissociation between myeloperoxidase (MPO)-modified LDL and MPO elevations during chronic sleep restriction and recovery in healthy young men. PLoS One. 2011;6(11):e28230.CrossRefPubMed
18.
go back to reference Faraut B, Boudjeltia KZ, Vanhamme L, Kerkhofs M. Immune, inflammatory and cardiovascular consequences of sleep restriction and recovery. Sleep Med Rev. 2012;16(2):137–49.CrossRefPubMed Faraut B, Boudjeltia KZ, Vanhamme L, Kerkhofs M. Immune, inflammatory and cardiovascular consequences of sleep restriction and recovery. Sleep Med Rev. 2012;16(2):137–49.CrossRefPubMed
19.
go back to reference Weil BR, et al. Short sleep duration is associated with enhanced endothelin-1 vasoconstrictor tone. Can J Physiol Pharmacol. 2010;88(8):777–81.CrossRefPubMed Weil BR, et al. Short sleep duration is associated with enhanced endothelin-1 vasoconstrictor tone. Can J Physiol Pharmacol. 2010;88(8):777–81.CrossRefPubMed
20.
go back to reference Chouchou F, et al. Sympathetic overactivity due to sleep fragmentation is associated with elevated diurnal systolic blood pressure in healthy elderly subjects: the PROOF-SYNAPSE study. Eur Heart J. 2013;34(28):2122–31, 2131a.CrossRefPubMed Chouchou F, et al. Sympathetic overactivity due to sleep fragmentation is associated with elevated diurnal systolic blood pressure in healthy elderly subjects: the PROOF-SYNAPSE study. Eur Heart J. 2013;34(28):2122–31, 2131a.CrossRefPubMed
21.
go back to reference Dettoni JL, et al. Cardiovascular effects of partial sleep deprivation in healthy volunteers. J Appl Physiol (1985). 2012;113(2):232–6.CrossRef Dettoni JL, et al. Cardiovascular effects of partial sleep deprivation in healthy volunteers. J Appl Physiol (1985). 2012;113(2):232–6.CrossRef
22.
go back to reference Sauvet F, et al. Effect of acute sleep deprivation on vascular function in healthy subjects. J Appl Physiol (1985). 2010;108(1):68–75.CrossRef Sauvet F, et al. Effect of acute sleep deprivation on vascular function in healthy subjects. J Appl Physiol (1985). 2010;108(1):68–75.CrossRef
23.
go back to reference Zhong X, et al. Increased sympathetic and decreased parasympathetic cardiovascular modulation in normal humans with acute sleep deprivation. J Appl Physiol (1985). 2005;98(6):2024–32.CrossRef Zhong X, et al. Increased sympathetic and decreased parasympathetic cardiovascular modulation in normal humans with acute sleep deprivation. J Appl Physiol (1985). 2005;98(6):2024–32.CrossRef
24.
go back to reference Taheri S, Lin L, Austin D, Young T, Mignot E. Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index. PLoS Med. 2004;1(3):e62.CrossRefPubMedPubMedCentral Taheri S, Lin L, Austin D, Young T, Mignot E. Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index. PLoS Med. 2004;1(3):e62.CrossRefPubMedPubMedCentral
25.
go back to reference Cappuccio FP, Cooper D, D'Elia L, Strazzullo P, Miller MA. Sleep duration predicts cardiovascular outcomes: a systematic review and meta-analysis of prospective studies. Eur Heart J. 2011;32(12):1484–92.CrossRefPubMed Cappuccio FP, Cooper D, D'Elia L, Strazzullo P, Miller MA. Sleep duration predicts cardiovascular outcomes: a systematic review and meta-analysis of prospective studies. Eur Heart J. 2011;32(12):1484–92.CrossRefPubMed
26.
go back to reference Tuomilehto H, Peltonen M, Partinen M, Lavigne G, Eriksson JG, Herder C, et al. Sleep duration, lifestyle intervention, and incidence of type 2 diabetes in impaired glucose tolerance: the Finnish diabetes prevention study. Diabetes Care. 2009;32(11):1965–71.CrossRefPubMedPubMedCentral Tuomilehto H, Peltonen M, Partinen M, Lavigne G, Eriksson JG, Herder C, et al. Sleep duration, lifestyle intervention, and incidence of type 2 diabetes in impaired glucose tolerance: the Finnish diabetes prevention study. Diabetes Care. 2009;32(11):1965–71.CrossRefPubMedPubMedCentral
27.
go back to reference Cappuccio FP, Stranges S, Kandala NB, Miller MA, Taggart FM, Kumari M, et al. Gender-specific associations of short sleep duration with prevalent and incident hypertension: the Whitehall II study. Hypertension. 2007;50(4):693–700.CrossRefPubMed Cappuccio FP, Stranges S, Kandala NB, Miller MA, Taggart FM, Kumari M, et al. Gender-specific associations of short sleep duration with prevalent and incident hypertension: the Whitehall II study. Hypertension. 2007;50(4):693–700.CrossRefPubMed
28.
go back to reference Gangwisch JE, Heymsfield SB, Boden-Albala B, Buijs RM, Kreier F, Pickering TG, et al. Short sleep duration as a risk factor for hypertension: analyses of the first National Health and Nutrition Examination Survey. Hypertension. 2006;47(5):833–9.CrossRefPubMed Gangwisch JE, Heymsfield SB, Boden-Albala B, Buijs RM, Kreier F, Pickering TG, et al. Short sleep duration as a risk factor for hypertension: analyses of the first National Health and Nutrition Examination Survey. Hypertension. 2006;47(5):833–9.CrossRefPubMed
29.
go back to reference Haack M, Serrador J, Cohen D, Simpson N, Meier-Ewert H, Mullington JM. Increasing sleep duration to lower beat-to-beat blood pressure: a pilot study. J Sleep Res. 2013;22(3):295–304.CrossRefPubMed Haack M, Serrador J, Cohen D, Simpson N, Meier-Ewert H, Mullington JM. Increasing sleep duration to lower beat-to-beat blood pressure: a pilot study. J Sleep Res. 2013;22(3):295–304.CrossRefPubMed
30.
go back to reference Cakici M, Dogan A, Cetin M, Suner A, Caner A, Polat M, et al. Negative effects of acute sleep deprivation on left ventricular functions and cardiac repolarization in healthy young adults. Pacing Clin Electrophysiol. 2015;38(6):713–22.CrossRefPubMed Cakici M, Dogan A, Cetin M, Suner A, Caner A, Polat M, et al. Negative effects of acute sleep deprivation on left ventricular functions and cardiac repolarization in healthy young adults. Pacing Clin Electrophysiol. 2015;38(6):713–22.CrossRefPubMed
31.
go back to reference Ozer O, Ozbala B, Sari I, Davutoglu V, Maden E, Baltaci Y, et al. Acute sleep deprivation is associated with increased QT dispersion in healthy young adults. Pacing Clin Electrophysiol. 2008;31(8):979–84.CrossRefPubMed Ozer O, Ozbala B, Sari I, Davutoglu V, Maden E, Baltaci Y, et al. Acute sleep deprivation is associated with increased QT dispersion in healthy young adults. Pacing Clin Electrophysiol. 2008;31(8):979–84.CrossRefPubMed
32.
go back to reference Morovatdar N, Ebrahimi N, Rezaee R, Poorzand H, Bayat Tork MA, Sahebkar A. Sleep duration and risk of atrial fibrillation: a systematic review. J Atr Fibrillation. 2019;11(6):2132.CrossRefPubMedPubMedCentral Morovatdar N, Ebrahimi N, Rezaee R, Poorzand H, Bayat Tork MA, Sahebkar A. Sleep duration and risk of atrial fibrillation: a systematic review. J Atr Fibrillation. 2019;11(6):2132.CrossRefPubMedPubMedCentral
33.
go back to reference Ayas NT, White DP, Manson JE, Stampfer MJ, Speizer FE, Malhotra A, et al. A prospective study of sleep duration and coronary heart disease in women. Arch Intern Med. 2003;163(2):205–9.CrossRefPubMed Ayas NT, White DP, Manson JE, Stampfer MJ, Speizer FE, Malhotra A, et al. A prospective study of sleep duration and coronary heart disease in women. Arch Intern Med. 2003;163(2):205–9.CrossRefPubMed
34.
go back to reference Barger LK, et al. Obstructive Sleep Apnea, Shiftwork, and the risk of adverse cardiovascular events in patients after an acute coronary syndrome. J Am Heart Assoc. 2017;6(10). Barger LK, et al. Obstructive Sleep Apnea, Shiftwork, and the risk of adverse cardiovascular events in patients after an acute coronary syndrome. J Am Heart Assoc. 2017;6(10).
35.
go back to reference Chandola T, Ferrie JE, Perski A, Akbaraly T, Marmot MG. The effect of short sleep duration on coronary heart disease risk is greatest among those with sleep disturbance: a prospective study from the Whitehall II cohort. Sleep. 2010;33(6):739–44.CrossRefPubMedPubMedCentral Chandola T, Ferrie JE, Perski A, Akbaraly T, Marmot MG. The effect of short sleep duration on coronary heart disease risk is greatest among those with sleep disturbance: a prospective study from the Whitehall II cohort. Sleep. 2010;33(6):739–44.CrossRefPubMedPubMedCentral
36.
go back to reference Liu Y, et al. Sleep duration and chronic diseases among U.S. adults age 45 years and older: evidence from the 2010 behavioral risk factor surveillance system. Sleep. 2013;36(10):1421–7.CrossRefPubMedPubMedCentral Liu Y, et al. Sleep duration and chronic diseases among U.S. adults age 45 years and older: evidence from the 2010 behavioral risk factor surveillance system. Sleep. 2013;36(10):1421–7.CrossRefPubMedPubMedCentral
37.
go back to reference Kwok CS, et al. Self-reported sleep duration and quality and cardiovascular disease and mortality: a dose-response meta-analysis. J Am Heart Assoc. 2018;7(15):e008552.CrossRefPubMedPubMedCentral Kwok CS, et al. Self-reported sleep duration and quality and cardiovascular disease and mortality: a dose-response meta-analysis. J Am Heart Assoc. 2018;7(15):e008552.CrossRefPubMedPubMedCentral
38.
go back to reference •• Wang C, et al. Association of estimated sleep duration and naps with mortality and cardiovascular events: a study of 116 632 people from 21 countries. Eur Heart J. 2019;40(20):1620–9 A very large study showing both increased and decreased duration of sleep is associated with not only increased cardiovascular event but also mortality.CrossRefPubMed •• Wang C, et al. Association of estimated sleep duration and naps with mortality and cardiovascular events: a study of 116 632 people from 21 countries. Eur Heart J. 2019;40(20):1620–9 A very large study showing both increased and decreased duration of sleep is associated with not only increased cardiovascular event but also mortality.CrossRefPubMed
39.
go back to reference Thomson CA, Morrow KL, Flatt SW, Wertheim BC, Perfect MM, Ravia JJ, et al. Relationship between sleep quality and quantity and weight loss in women participating in a weight-loss intervention trial. Obesity (Silver Spring). 2012;20(7):1419–25.CrossRef Thomson CA, Morrow KL, Flatt SW, Wertheim BC, Perfect MM, Ravia JJ, et al. Relationship between sleep quality and quantity and weight loss in women participating in a weight-loss intervention trial. Obesity (Silver Spring). 2012;20(7):1419–25.CrossRef
40.
go back to reference • Al Khatib HK, et al. Sleep extension is a feasible lifestyle intervention in free-living adults who are habitually short sleepers: a potential strategy for decreasing intake of free sugars? A randomized controlled pilot study. Am J Clin Nutr. 2018;107(1):43–53 Although a short-term study but it showed that sleep extension is possible with behvioral help for sleep hygeine and increase in sleep duration showed decreased intake of sugars and fat, major factors in development of metabolic syndrome.CrossRefPubMedPubMedCentral • Al Khatib HK, et al. Sleep extension is a feasible lifestyle intervention in free-living adults who are habitually short sleepers: a potential strategy for decreasing intake of free sugars? A randomized controlled pilot study. Am J Clin Nutr. 2018;107(1):43–53 Although a short-term study but it showed that sleep extension is possible with behvioral help for sleep hygeine and increase in sleep duration showed decreased intake of sugars and fat, major factors in development of metabolic syndrome.CrossRefPubMedPubMedCentral
41.
go back to reference Tasali E, Chapotot F, Wroblewski K, Schoeller D. The effects of extended bedtimes on sleep duration and food desire in overweight young adults: a home-based intervention. Appetite. 2014;80:220–4.CrossRefPubMedPubMedCentral Tasali E, Chapotot F, Wroblewski K, Schoeller D. The effects of extended bedtimes on sleep duration and food desire in overweight young adults: a home-based intervention. Appetite. 2014;80:220–4.CrossRefPubMedPubMedCentral
42.
go back to reference Scheer FA, van Montfrans G, van Someren E, Mairuhu G, Buijs RM. Daily nighttime melatonin reduces blood pressure in male patients with essential hypertension. Hypertension. 2004;43(2):192–7.CrossRefPubMed Scheer FA, van Montfrans G, van Someren E, Mairuhu G, Buijs RM. Daily nighttime melatonin reduces blood pressure in male patients with essential hypertension. Hypertension. 2004;43(2):192–7.CrossRefPubMed
43.
go back to reference Aurora RN, Crainiceanu C, Gottlieb DJ, Kim JS, Punjabi NM. Obstructive sleep apnea during REM sleep and cardiovascular disease. Am J Respir Crit Care Med. 2018;197(5):653–60.CrossRefPubMedPubMedCentral Aurora RN, Crainiceanu C, Gottlieb DJ, Kim JS, Punjabi NM. Obstructive sleep apnea during REM sleep and cardiovascular disease. Am J Respir Crit Care Med. 2018;197(5):653–60.CrossRefPubMedPubMedCentral
44.
go back to reference Floras JS. Sleep apnea and cardiovascular disease: an enigmatic risk factor. Circ Res. 2018;122(12):1741–64.CrossRefPubMed Floras JS. Sleep apnea and cardiovascular disease: an enigmatic risk factor. Circ Res. 2018;122(12):1741–64.CrossRefPubMed
45.
go back to reference Young T, Palta M, Dempsey J, Peppard PE, Nieto FJ, Hla KM. Burden of sleep apnea: rationale, design, and major findings of the Wisconsin sleep cohort study. WMJ. 2009;108(5):246–9.PubMedPubMedCentral Young T, Palta M, Dempsey J, Peppard PE, Nieto FJ, Hla KM. Burden of sleep apnea: rationale, design, and major findings of the Wisconsin sleep cohort study. WMJ. 2009;108(5):246–9.PubMedPubMedCentral
46.
go back to reference Pack AI, Gislason T. Obstructive sleep apnea and cardiovascular disease: a perspective and future directions. Prog Cardiovasc Dis. 2009;51(5):434–51.CrossRefPubMed Pack AI, Gislason T. Obstructive sleep apnea and cardiovascular disease: a perspective and future directions. Prog Cardiovasc Dis. 2009;51(5):434–51.CrossRefPubMed
47.
go back to reference Arnardottir ES, Mackiewicz M, Gislason T, Teff KL, Pack AI. Molecular signatures of obstructive sleep apnea in adults: a review and perspective. Sleep. 2009;32(4):447–70.CrossRefPubMedPubMedCentral Arnardottir ES, Mackiewicz M, Gislason T, Teff KL, Pack AI. Molecular signatures of obstructive sleep apnea in adults: a review and perspective. Sleep. 2009;32(4):447–70.CrossRefPubMedPubMedCentral
48.
go back to reference Lisan Q, van Sloten T, Marques Vidal P, Haba Rubio J, Heinzer R, Empana JP. Association of positive airway pressure prescription with mortality in patients with obesity and severe obstructive sleep apnea: the sleep heart health study. JAMA Otolaryngol Head Neck Surg. 2019;145(6):509–15.CrossRefPubMedPubMedCentral Lisan Q, van Sloten T, Marques Vidal P, Haba Rubio J, Heinzer R, Empana JP. Association of positive airway pressure prescription with mortality in patients with obesity and severe obstructive sleep apnea: the sleep heart health study. JAMA Otolaryngol Head Neck Surg. 2019;145(6):509–15.CrossRefPubMedPubMedCentral
Metadata
Title
Effects of Sleep Duration on Cardiovascular Events
Authors
Adeel Ahmad
S. Claudia Didia
Publication date
01-04-2020
Publisher
Springer US
Keyword
Sleep Apnea
Published in
Current Cardiology Reports / Issue 4/2020
Print ISSN: 1523-3782
Electronic ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-020-1271-0

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