title: Sleep disturbance and cardiovascular risk in adolescents.
abstract: BACKGROUND
  Evidence suggests that inadequate or disturbed sleep is associated with increased cardiovascular risk in adults. There are limited data on sleep quality and associated cardiovascular risk in children.
  
  
  METHODS
  We obtained data on adolescents from the 2009/10 cycle of the Healthy Heart Schools' Program, a population-based cross-sectional study in the Niagara region of Ontario. Participants underwent measurements of cardiometabolic risk factors, including body mass index (BMI), lipid profile and blood pressure, and they completed questionnaires measuring sleeping habits and nutritional status. We assessed sleep disturbance using the sleep disturbance score derived from the Pittsburgh Sleep Quality Index. We explored associations between sleeping habits and cardiovascular risk factors.
  
  
  RESULTS
  Among 4104 adolescents (51% male), the mean hours of sleep per night (± standard deviation) were 7.9 ± 1.1 on weeknights and 9.4 ± 1.6 on weekends. In total, 19% of participants reported their sleep quality as fairly bad or very bad on weeknights and 10% reported it as fairly bad or very bad on weekends. In the multivariable regression models, a higher sleep disturbance score was associated with increased odds of being at high cardiovascular risk (highest v. lowest tertile odds ratio [OR] 1.43 [95% confidence interval (CI) 1.16-1.77], p < 0.001), increased odds of hypertension (highest v. lowest tertile OR 1.44 [95% CI 1.02-2.05], p = 0.05) and increased odds of elevated non-high density lipoprotein cholesterol (highest v. lowest tertile OR 1.28 [95% CI 1.00-1.64], p = 0.05). The mean duration of sleep was not associated with these outcomes.
  
  
  CONCLUSIONS
  In healthy adolescents, sleep disturbance is associated with cardiovascular risk factor abnormalities. Intervention strategies to optimize sleep hygiene early in life may be important for the prevention of cardiovascular disease.
authors.affiliation: Department of Respiratory Medicine, University of Toronto, The Hospital for Sick Children, Toronto, Ont.
authors.forename: Indra
authors.initials: I
authors.lastname: Narang
authors.forename: Cedric
authors.initials: C
authors.lastname: Manlhiot
authors.forename: Jolie
authors.initials: J
authors.lastname: Davies-Shaw
authors.forename: Don
authors.initials: D
authors.lastname: Gibson
authors.forename: Nita
authors.initials: N
authors.lastname: Chahal
authors.forename: Karen
authors.initials: K
authors.lastname: Stearne
authors.forename: Amanda
authors.initials: A
authors.lastname: Fisher
authors.forename: Stafford
authors.initials: S
authors.lastname: Dobbin
authors.forename: Brian W
authors.initials: BW
authors.lastname: McCrindle
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000235:genetics; D002784:Cholesterol / Q000097:blood; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D015999:Multivariate Analysis; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000453:epidemiology*
chemical_list: D002784:Cholesterol