Sleep duration and cardiovascular disease: results from the National Health Interview Survey.
BACKGROUND
Previous studies have shown that both short and long sleep durations are related to increased likelihood of diabetes and hypertension. However, the relation between sleep duration and cardiovascular disease (CVD) is not clear. We examined the hypothesis that compared with sleep duration of 7 hours, shorter and longer sleep durations are independently related to CVD.


METHODS
We conducted a cross-sectional study of 30,397 National Health Interview Survey 2005 participants > or = 18 years of age (57.1% women). Sleep duration was categorized as < or = 5 hours, 6 hours, 7 hours, 8 hours, and > or = 9 hours. The main outcome of interest was the presence of any CVD (n = 2146), including myocardial infarction, angina, and stroke.


RESULTS
We found both short and long sleep durations to be independently associated with CVD, independent of age, sex, race-ethnicity, smoking, alcohol intake, body mass index, physical activity, diabetes mellitus, hypertension, and depression. Compared with a sleep duration of 7 h (referent), the multivariate odds ratio (95% confidence interval) of CVD was 2.20 (1.78, 2.71), 1.33 (1.13, 1.57), 1.23 (1.06, 1.41), and 1.57 (1.31, 1.89) for sleep duration < or = 5 h, 6 h, 8 h, and > or = 9 h. This association persisted in subgroup analyses by gender, race-ethnicity, and body mass index categories. Also, similar associations were observed when we examined myocardial infarction and stroke separately.


CONCLUSIONS
Compared with sleep duration of 7 h, there was a positive association between both shorter and longer sleep durations and CVD in a representative sample of US adults. These results suggest that sleep duration may be an important marker of CVD.
Sabanayagam
Charumathi
C
Department of Community Medicine, West Virginia University School of Medicine, Morgantown, WV 26505-9190, USA.
Shankar
Anoop
A
D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology; D000787:Angina Pectoris / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D006970:Disorders of Excessive Somnolence / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000453:epidemiology; D016017:Odds Ratio; D012307:Risk Factors; D012892:Sleep Deprivation / Q000453:epidemiology*; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D013223:Statistics as Topic; D020521:Stroke / Q000453:epidemiology
Int Angiol. 2009 Apr;28(2):92-9
19367238
Sleep. 2004 May 1;27(3):440-4
15164896
Neurology. 1997 Apr;48(4):904-11
9109875
Diabetes Care. 2007 May;30(5):1233-40
17322482
Sleep. 2004 Feb 1;27(1):51-4
14998237
Lancet. 1999 Oct 23;354(9188):1435-9
10543671
Arch Intern Med. 2008 Nov 10;168(20):2225-31
19001199
Am J Epidemiol. 2005 Feb 15;161(4):368-76
15692081
Arch Gen Psychiatry. 2002 Feb;59(2):131-6
11825133
J Sleep Res. 2009 Jun;18(2):148-58
19645960
World Health Organ Tech Rep Ser. 2000;894:i-xii, 1-253
11234459
J Gen Intern Med. 2007 Jun;22(6):841-6
17503110
Vital Health Stat 10. 2006 Dec;(232):1-153
17252928
Horm Res. 2007;67 Suppl 1:2-9
17308390
Curr Probl Cardiol. 2005 Dec;30(12):625-62
16301095
Int J Obes (Lond). 2008 Jul;32(7):1083-90
18414418
Sleep. 2006 Jul;29(7):881-9
16895254
Am J Epidemiol. 2008 Dec 15;168(12):1367-73
18952563
Sleep. 2006 Aug;29(8):1009-14
16944668
Sleep. 2008 May;31(5):645-52
18517035
Arch Intern Med. 2003 Jan 27;163(2):205-9
12546611
Arch Intern Med. 2005 Apr 25;165(8):863-7
15851636
Stroke. 2008 Dec;39(12):3185-92
18635832
Am J Public Health. 2003 Oct;93(10):1740-7
14534231
Sleep. 2007 Sep;30(9):1121-7
17910384
Exp Clin Endocrinol Diabetes. 2005 Dec;113(10):563-7
16320152
Sleep. 2002 Feb 1;25(1):68-87
11833857
Am J Epidemiol. 2009 May 1;169(9):1052-63
19299406
Prev Med. 2009 Aug-Sep;49(2-3):135-41
19573557
Obesity (Silver Spring). 2008 Mar;16(3):643-53
18239586
Essent Psychopharmacol. 2005;6(6):341-7
16459757
Sleep. 2009 Mar;32(3):295-301
19294949
J Sleep Res. 1999 Sep;8(3):175-83
10476003