title: The association between sleep characteristics and prothrombotic markers in a population-based sample: Chicago Area Sleep Study.
abstract: OBJECTIVE
  Short sleep duration and poor quality sleep are associated with coronary heart disease (CHD) mortality; however, the underlying pathophysiologic process remains unclear. Sleep apnea may confound the association because of its relationship with formation of thrombi, the vascular occlusive process in CHD. We tested whether sleep duration and quality were associated with prothrombotic biomarkers in adults with a low probability of apnea.
  
  
  METHODS
  We included adults aged 35-64 years recruited from the community and who had an apnea hypopnea index <15 after one night of screening (n=506). Sleep duration and maintenance were determined from 7 days of wrist actigraphy; daytime sleepiness was estimated using the Epworth Sleepiness Scale. Factor VIII (FVIII), von Willebrand factor (vWF), thrombin antithrombin (TAT) complexes, and plasminogen activator inhibitor-1 (PAI-1) were measured in fasting blood.
  
  
  RESULTS
  Sleep duration, maintenance, and daytime sleepiness were not associated with FVIII, vWf, or TAT. Sleep maintenance was modestly inversely associated with higher levels of log-transformed PAI-1 (β = -0.07, standard error (SE)=0.03 per 4.8%, p=0.04) following adjustment for demographic characteristics, cardiovascular risk factors, and body mass index (BMI).
  
  
  CONCLUSIONS
  Mild impairment in sleep was modestly associated with activation of coagulation; further study is needed to evaluate the role of fibrinolytic factors in sleep-mediated coronary thrombosis.
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Chicago, IL, USA.
authors.forename: Zehra
authors.initials: Z
authors.lastname: Tosur
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Chicago, IL, USA.
authors.forename: David
authors.initials: D
authors.lastname: Green
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine of Northwestern University, Chicago, IL, USA.
authors.forename: Peter John
authors.initials: PJ
authors.lastname: De Chavez
authors.affiliation: Department of Medicine, University of Chicago, Chicago, IL, USA.
authors.forename: Kristen L
authors.initials: KL
authors.lastname: Knutson
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine of Northwestern University, Chicago, IL, USA.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Goldberger
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine of Northwestern University, Chicago, IL, USA.
authors.forename: Phyllis
authors.initials: P
authors.lastname: Zee
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine of Northwestern University, Chicago, IL, USA.
authors.forename: Kiang
authors.initials: K
authors.lastname: Liu
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine of Northwestern University, Chicago, IL, USA.
authors.forename: Kwang-Youn
authors.initials: KY
authors.lastname: Kim
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine of Northwestern University, Chicago, IL, USA. Electronic address: carnethon@northwestern.edu.
authors.forename: Mercedes R
authors.initials: MR
authors.lastname: Carnethon
mesh_terms: D056044:Actigraphy; D000328:Adult; D000990:Antithrombin III; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D005169:Factor VIII / Q000032:analysis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010447:Peptide Hydrolases / Q000097:blood*; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D012890:Sleep / Q000502:physiology; D012892:Sleep Deprivation / Q000097:blood / Q000150:complications; D012893:Sleep Wake Disorders / Q000097:blood* / Q000150:complications; D011795:Surveys and Questionnaires; D013927:Thrombosis / Q000097:blood / Q000209:etiology; D014841:von Willebrand Factor / Q000032:analysis*
chemical_list: D015415:Biomarkers; D017395:Plasminogen Activator Inhibitor 1; C046193:antithrombin III-protease complex; D014841:von Willebrand Factor; D000990:Antithrombin III; D005169:Factor VIII; D010447:Peptide Hydrolases
keywords: Cardiovascular disease; Hemostatic factors; Population studies; Procoagulants; Sleep apnea; Sleep duration