Skip to main content
Top
Published in: BMC Cardiovascular Disorders 1/2021

Open Access 01-12-2021 | Research article

Digital health device measured sleep duration and ideal cardiovascular health: an observational study

Authors: Jane A. Leopold, Elliott M. Antman

Published in: BMC Cardiovascular Disorders | Issue 1/2021

Login to get access

Abstract

Background

Studies relying on self-reported sleep data suggest that there is an association between short and long sleep duration and less than ideal cardiovascular health. Evidence regarding the feasibility of using digital health devices to measure sleep duration and assess its relationship to ideal cardiovascular health are lacking. The objective of the present study was to utilize digital health devices to record sleep duration and examine the relationship between sleep duration and ideal cardiovascular health.

Methods

A total of 307 participants transmitted sleep duration data from digital health devices and answered the Life’s Simple 7 survey instrument to assess ideal cardiovascular health. Sleep duration was defined as adequate (7 to < 9 h per night) or non-adequate (< 7 h and ≥ 9 h).

Results

We identified three sleep-cardiovascular health phenogroups: resilient (non-adequate sleep and ideal cardiovascular health), uncoupled (adequate sleep and non-ideal cardiovascular health) or concordant (sleep and cardiovascular health metrics were aligned). Participants in the resilient phenogroup (n = 83) had better cardiovascular health factor profiles (blood pressure, blood glucose and cholesterol levels) and behaviors (healthy weight, diet, exercise, smoking) than participants in the concordant (n = 171) and uncoupled (n = 53) phenogroups. This was associated with higher Life’s Simple 7 Health Scores in the resilient phenogroup compared to the concordant and uncoupled phenogroups (7.8 ± 0.8 vs. 7.0 ± 1.4 vs. 5.6 ± 0.7, P < 0.01).

Conclusion

This study identified three distinct sleep-ideal cardiovascular health phenogroups and highlights the advantage of incorporating sleep assessments into studies of cardiovascular health. Future studies should focus on the relationship between sleep-cardiovascular phenogroups and clinical outcomes.
Clinical Trial Registration Clinicaltrials.gov NCT02958098. Date of registration: November 11, 2016.
Literature
1.
go back to reference Liu Y, Wheaton AG, Chapman DP, Cunningham TJ, Lu H, Croft JB. Prevalence of healthy sleep duration among adults–United States, 2014. MMWR Morb Mortal Wkly Rep. 2016;65(6):137–41.CrossRef Liu Y, Wheaton AG, Chapman DP, Cunningham TJ, Lu H, Croft JB. Prevalence of healthy sleep duration among adults–United States, 2014. MMWR Morb Mortal Wkly Rep. 2016;65(6):137–41.CrossRef
2.
go back to reference Watson NF, Horn E, Duncan GE, Buchwald D, Vitiello MV, Turkheimer E. Sleep duration and area-level deprivation in twins. Sleep. 2016;39(1):67–77.CrossRef Watson NF, Horn E, Duncan GE, Buchwald D, Vitiello MV, Turkheimer E. Sleep duration and area-level deprivation in twins. Sleep. 2016;39(1):67–77.CrossRef
3.
go back to reference Yin J, Jin X, Shan Z, Li S, Huang H, Li P, et al. Relationship of sleep duration with all-cause mortality and cardiovascular events: a systematic review and dose-response meta-analysis of prospective cohort studies. J Am Heart Assoc. 2017;6(9):e005947.CrossRef Yin J, Jin X, Shan Z, Li S, Huang H, Li P, et al. Relationship of sleep duration with all-cause mortality and cardiovascular events: a systematic review and dose-response meta-analysis of prospective cohort studies. J Am Heart Assoc. 2017;6(9):e005947.CrossRef
4.
go back to reference Covassin N, Singh P. Sleep duration and cardiovascular disease risk: epidemiologic and experimental evidence. Sleep Med Clin. 2016;11(1):81–9.CrossRef Covassin N, Singh P. Sleep duration and cardiovascular disease risk: epidemiologic and experimental evidence. Sleep Med Clin. 2016;11(1):81–9.CrossRef
5.
go back to reference Aggarwal S, Loomba RS, Arora RR, Molnar J. Associations between sleep duration and prevalence of cardiovascular events. Clin Cardiol. 2013;36(11):671–6.CrossRef Aggarwal S, Loomba RS, Arora RR, Molnar J. Associations between sleep duration and prevalence of cardiovascular events. Clin Cardiol. 2013;36(11):671–6.CrossRef
6.
go back to reference Liu Y, Wheaton AG, Chapman DP, Croft JB. 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.CrossRef Liu Y, Wheaton AG, Chapman DP, Croft JB. 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.CrossRef
7.
go back to reference Sabanayagam C, Shankar A. Sleep duration and cardiovascular disease: results from the National Health Interview Survey. Sleep. 2010;33(8):1037–42.CrossRef Sabanayagam C, Shankar A. Sleep duration and cardiovascular disease: results from the National Health Interview Survey. Sleep. 2010;33(8):1037–42.CrossRef
8.
go back to reference Merikanto I, Lahti T, Puolijoki H, Vanhala M, Peltonen M, Laatikainen T, et al. Associations of chronotype and sleep with cardiovascular diseases and type 2 diabetes. Chronobiol Int. 2013;30(4):470–7.CrossRef Merikanto I, Lahti T, Puolijoki H, Vanhala M, Peltonen M, Laatikainen T, et al. Associations of chronotype and sleep with cardiovascular diseases and type 2 diabetes. Chronobiol Int. 2013;30(4):470–7.CrossRef
9.
go back to reference Fang J, Wheaton AG, Keenan NL, Greenlund KJ, Perry GS, Croft JB. Association of sleep duration and hypertension among US adults varies by age and sex. Am J Hypertens. 2012;25(3):335–41.CrossRef Fang J, Wheaton AG, Keenan NL, Greenlund KJ, Perry GS, Croft JB. Association of sleep duration and hypertension among US adults varies by age and sex. Am J Hypertens. 2012;25(3):335–41.CrossRef
10.
go back to reference Gangwisch JE, Feskanich D, Malaspina D, Shen S, Forman JP. Sleep duration and risk for hypertension in women: results from the nurses’ health study. Am J Hypertens. 2013;26(7):903–11.CrossRef Gangwisch JE, Feskanich D, Malaspina D, Shen S, Forman JP. Sleep duration and risk for hypertension in women: results from the nurses’ health study. Am J Hypertens. 2013;26(7):903–11.CrossRef
11.
go back to reference Lloyd-Jones DM, Hong Y, Labarthe D, Mozaffarian D, Appel LJ, Van Horn L, et al. Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association’s strategic Impact Goal through 2020 and beyond. Circulation. 2010;121(4):586–613.CrossRef Lloyd-Jones DM, Hong Y, Labarthe D, Mozaffarian D, Appel LJ, Van Horn L, et al. Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association’s strategic Impact Goal through 2020 and beyond. Circulation. 2010;121(4):586–613.CrossRef
12.
go back to reference Sanchez E. Life’s simple 7: vital but not easy. J Am Heart Assoc. 2018;7(11):e009324.CrossRef Sanchez E. Life’s simple 7: vital but not easy. J Am Heart Assoc. 2018;7(11):e009324.CrossRef
13.
go back to reference Enserro DM, Vasan RS, Xanthakis V. Twenty-year trends in the American Heart Association Cardiovascular Health Score and impact on subclinical and clinical cardiovascular disease: the framingham offspring study. J Am Heart Assoc. 2018;7(11):e008741.CrossRef Enserro DM, Vasan RS, Xanthakis V. Twenty-year trends in the American Heart Association Cardiovascular Health Score and impact on subclinical and clinical cardiovascular disease: the framingham offspring study. J Am Heart Assoc. 2018;7(11):e008741.CrossRef
14.
go back to reference Corlin L, Short MI, Vasan RS, Xanthakis V. Association of the duration of ideal cardiovascular health through adulthood with cardiometabolic outcomes and mortality in the framingham offspring study. JAMA Cardiol. 2020;5(5):549–56.CrossRef Corlin L, Short MI, Vasan RS, Xanthakis V. Association of the duration of ideal cardiovascular health through adulthood with cardiometabolic outcomes and mortality in the framingham offspring study. JAMA Cardiol. 2020;5(5):549–56.CrossRef
15.
go back to reference Nguyen ATH, Saeed A, Bambs CE, Swanson J, Emechebe N, Mansuri F, et al. Usefulness of the American Heart Association’s ideal cardiovascular health measure to predict long-term major adverse cardiovascular events (From the Heart SCORE Study). Am J Cardiol. 2021;138:20–5.CrossRef Nguyen ATH, Saeed A, Bambs CE, Swanson J, Emechebe N, Mansuri F, et al. Usefulness of the American Heart Association’s ideal cardiovascular health measure to predict long-term major adverse cardiovascular events (From the Heart SCORE Study). Am J Cardiol. 2021;138:20–5.CrossRef
16.
go back to reference Ramirez-Velez R, Saavedra JM, Lobelo F, Celis-Morales CA, Pozo-Cruz BD, Garcia-Hermoso A. Ideal cardiovascular health and incident cardiovascular disease among adults: a systematic review and meta-analysis. Mayo Clin Proc. 2018;93(11):1589–99.CrossRef Ramirez-Velez R, Saavedra JM, Lobelo F, Celis-Morales CA, Pozo-Cruz BD, Garcia-Hermoso A. Ideal cardiovascular health and incident cardiovascular disease among adults: a systematic review and meta-analysis. Mayo Clin Proc. 2018;93(11):1589–99.CrossRef
17.
go back to reference Ommerborn MJ, Blackshear CT, Hickson DA, Griswold ME, Kwatra J, Djousse L, et al. Ideal cardiovascular health and incident cardiovascular events: the jackson heart study. Am J Prev Med. 2016;51(4):502–6.CrossRef Ommerborn MJ, Blackshear CT, Hickson DA, Griswold ME, Kwatra J, Djousse L, et al. Ideal cardiovascular health and incident cardiovascular events: the jackson heart study. Am J Prev Med. 2016;51(4):502–6.CrossRef
18.
go back to reference Makarem N, St-Onge MP, Liao M, Lloyd-Jones DM, Aggarwal B. Association of sleep characteristics with cardiovascular health among women and differences by race/ethnicity and menopausal status: findings from the American Heart Association Go Red for Women Strategically Focused Research Network. Sleep Health. 2019;5(5):501–8.CrossRef Makarem N, St-Onge MP, Liao M, Lloyd-Jones DM, Aggarwal B. Association of sleep characteristics with cardiovascular health among women and differences by race/ethnicity and menopausal status: findings from the American Heart Association Go Red for Women Strategically Focused Research Network. Sleep Health. 2019;5(5):501–8.CrossRef
19.
go back to reference Cash RE, Beverly Hery CM, Panchal AR, Bower JK. Association between sleep duration and ideal cardiovascular health among US adults, national health and nutrition examination survey, 2013–2016. Prev Chronic Dis. 2020;17:E43.CrossRef Cash RE, Beverly Hery CM, Panchal AR, Bower JK. Association between sleep duration and ideal cardiovascular health among US adults, national health and nutrition examination survey, 2013–2016. Prev Chronic Dis. 2020;17:E43.CrossRef
20.
go back to reference Leopold JA, Davis RB, Antman EM. Data from digital health devices informs ideal cardiovascular health. J Personal Med. 2021;11(3):189.CrossRef Leopold JA, Davis RB, Antman EM. Data from digital health devices informs ideal cardiovascular health. J Personal Med. 2021;11(3):189.CrossRef
21.
go back to reference Haghayegh S, Khoshnevis S, Smolensky MH, Diller KR, Castriotta RJ. Accuracy of wristband fitbit models in assessing sleep: systematic review and meta-analysis. J Med Internet Res. 2019;21(11):e16273.CrossRef Haghayegh S, Khoshnevis S, Smolensky MH, Diller KR, Castriotta RJ. Accuracy of wristband fitbit models in assessing sleep: systematic review and meta-analysis. J Med Internet Res. 2019;21(11):e16273.CrossRef
22.
go back to reference Angell SY, McConnell MV, Anderson CAM, Bibbins-Domingo K, Boyle DS, Capewell S, et al. The American Heart Association 2030 Impact Goal: a presidential advisory from the American Heart Association. Circulation. 2020;141(9):e120–38.CrossRef Angell SY, McConnell MV, Anderson CAM, Bibbins-Domingo K, Boyle DS, Capewell S, et al. The American Heart Association 2030 Impact Goal: a presidential advisory from the American Heart Association. Circulation. 2020;141(9):e120–38.CrossRef
23.
go back to reference Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, et al. Heart disease and stroke statistics-2020 update: a report from the American Heart Association. Circulation. 2020;141(9):e139–596.CrossRef Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, et al. Heart disease and stroke statistics-2020 update: a report from the American Heart Association. Circulation. 2020;141(9):e139–596.CrossRef
25.
go back to reference Patterson F, Malone SK, Grandner MA, Lozano A, Perkett M, Hanlon A. Interactive effects of sleep duration and morning/evening preference on cardiovascular risk factors. Eur J Public Health. 2018;28(1):155–61.CrossRef Patterson F, Malone SK, Grandner MA, Lozano A, Perkett M, Hanlon A. Interactive effects of sleep duration and morning/evening preference on cardiovascular risk factors. Eur J Public Health. 2018;28(1):155–61.CrossRef
26.
go back to reference Kim CR, Song YM, Shin JY, Gim W. Association between sleep duration and impaired fasting glucose in korean adults: results from the Korean National Health and Nutrition Examination Survey 2011–2012. Korean J Fam Med. 2016;37(1):51–6.CrossRef Kim CR, Song YM, Shin JY, Gim W. Association between sleep duration and impaired fasting glucose in korean adults: results from the Korean National Health and Nutrition Examination Survey 2011–2012. Korean J Fam Med. 2016;37(1):51–6.CrossRef
27.
go back to reference Reis C, Dias S, Rodrigues AM, Sousa RD, Gregorio MJ, Branco J, et al. Sleep duration, lifestyles and chronic diseases: a cross-sectional population-based study. Sleep Sci. 2018;11(4):217–30.CrossRef Reis C, Dias S, Rodrigues AM, Sousa RD, Gregorio MJ, Branco J, et al. Sleep duration, lifestyles and chronic diseases: a cross-sectional population-based study. Sleep Sci. 2018;11(4):217–30.CrossRef
28.
go back to reference Kim CW, Chang Y, Zhao D, Cainzos-Achirica M, Ryu S, Jung HS, et al. Sleep Duration, Sleep quality, and markers of subclinical arterial disease in healthy men and women. Arterioscler Thromb Vasc Biol. 2015;35(10):2238–45.CrossRef Kim CW, Chang Y, Zhao D, Cainzos-Achirica M, Ryu S, Jung HS, et al. Sleep Duration, Sleep quality, and markers of subclinical arterial disease in healthy men and women. Arterioscler Thromb Vasc Biol. 2015;35(10):2238–45.CrossRef
29.
go back to reference Kobayashi D, Kuriyama N, Osugi Y, Arioka H, Takahashi O. Longitudinal relationships between cardiovascular events, risk factors, and time-dependent sleep duration. Cardiol J. 2018;25(2):229–35.PubMed Kobayashi D, Kuriyama N, Osugi Y, Arioka H, Takahashi O. Longitudinal relationships between cardiovascular events, risk factors, and time-dependent sleep duration. Cardiol J. 2018;25(2):229–35.PubMed
30.
go back to reference Cummings SR. Clinical trials without clinical sites. JAMA Intern Med. 2021;181(5):680–84.CrossRef Cummings SR. Clinical trials without clinical sites. JAMA Intern Med. 2021;181(5):680–84.CrossRef
31.
go back to reference de Zambotti M, Cellini N, Goldstone A, Colrain IM, Baker FC. Wearable sleep technology in clinical and research settings. Med Sci Sports Exerc. 2019;51(7):1538–57.CrossRef de Zambotti M, Cellini N, Goldstone A, Colrain IM, Baker FC. Wearable sleep technology in clinical and research settings. Med Sci Sports Exerc. 2019;51(7):1538–57.CrossRef
32.
go back to reference Meng Y, Speier W, Shufelt C, Joung S, Van Eyk JE, Bairey Merz CN, et al. A machine learning approach to classifying self-reported health status in a cohort of patients with heart disease using activity tracker data. IEEE J Biomed Health Inform. 2020;24(3):878–84.CrossRef Meng Y, Speier W, Shufelt C, Joung S, Van Eyk JE, Bairey Merz CN, et al. A machine learning approach to classifying self-reported health status in a cohort of patients with heart disease using activity tracker data. IEEE J Biomed Health Inform. 2020;24(3):878–84.CrossRef
Metadata
Title
Digital health device measured sleep duration and ideal cardiovascular health: an observational study
Authors
Jane A. Leopold
Elliott M. Antman
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2021
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-021-02284-z

Other articles of this Issue 1/2021

BMC Cardiovascular Disorders 1/2021 Go to the issue