By Alan Z. Segal, MD
Associate Professor of Clinical Neurology, Weill Cornell Medical College
Dr. Segal reports no financial relationships relevant to this field of study.
SOURCE: Dominguez Rodriguez F, Fernandez Alvira JM, Fernandez Friera L, et al. Association of actigraphy-measured sleep parameters and subclinical atherosclerotic burden: The PESA study. Eur Heart J 2018;39(Suppl 1):P2466.
Insufficient and poor quality sleep can lead to significant medical complications including atherosclerotic disease. Dominguez Rodriguez et al studied 2,974 patients in the Progression and Early Detection of Subclinical Atherosclerosis (PESA) cohort. Subjects were screened using 2D/3D ultrasound in the carotid, abdominal aorta, and iliofemoral arteries. A coronary artery calcium score on CT also was calculated. Movement sensors (actigraphy) were used to measure sleep duration during a one-week period. Actigraphy is a useful surrogate for more invasive types of sleep monitoring such as polysomnography. Subjects were stratified into four groups: markedly short sleep (< 6 hours), short sleep (6-7 hours), average reference (7-8 hours), and long sleep (> 8 hours). Sleep duration of less than six hours was associated with a mildly increased odds of atherosclerosis on ultrasound, although not on cardiac calcium (odds ratio [OR], 1.27; 95% CI, 1.06-1.52). Subjects with the most fragmented sleep (bottom 20%) had an increased risk of atherosclerosis as well (OR, 1.35; 95% CI, 1.05-1.65). The diagnosis of metabolic syndrome also was made more frequently in the subjects with short or disrupted sleep. This research corroborates prior data, although some previous studies have suggested a more complex U-shaped curve, putting both short sleepers and excessively long sleepers at risk for atherosclerotic disease. Regardless, these data provide further support for the importance of sleep in the optimization of medical outcomes.