Insomnia Symptoms Are Associated With Abnormal Endothelial Function.
BACKGROUND
Insomnia is a prevalent sleep disorder, and it has been increasingly associated with cardiovascular morbidity and mortality. The reasons for this relationship are not completely understood but may involve endothelial dysfunction. In this study, we hypothesized that insomnia symptoms would be associated with reduced endothelial function.


METHODS
Working adults (n = 496, 67.5% female, 78.6% white, mean age 48.7 [SD, 10.8] years, body mass index 28.2 [SD, 6.7] kg/m, diabetes 5.8%, hypertension 20.0%, hyperlipidemia 17.9%, heart disease 2.6%) enrolled in the Emory-Georgia Tech Predictive Health Institute study completed baseline demographic, clinical, depression (Beck Depression Inventory II), anxiety (General Anxiety Disorder 7), sleep (Pittsburg Sleep Quality Index), and noninvasive endothelial function (brachial artery flow-mediated dilation [FMD]) measures. Insomnia symptoms were defined as subjective sleep latency of 30 minutes or longer, nighttime or early morning awakenings, and/or sleep medication use occurring 3 times or more per week in the past month.


RESULTS
Insomnia symptoms were reported by 39.5% of participants. Multivariable regression models showed that insomnia symptoms, age, baseline artery diameter, and dyslipidemia were inversely related to FMD. After adjusting for age, baseline artery diameter, and dyslipidemia, participants reporting insomnia symptoms had lower FMD than did participants reporting better sleep (adjusted FMD mean, 6.13% [SD, 0.28%] vs 6.83% [SD, 0.26%], P = .035).


CONCLUSIONS
In this study, insomnia symptoms were associated with reduced FMD. Research examining the therapeutic benefits of treating insomnia on endothelial function and future cardiovascular risk is warranted.
Faye S. Routledge, PhD, RN Assistant Professor, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia. Sandra B. Dunbar, PhD, RN Professor, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia. Melinda Higgins, PhD Associate Professor, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia. Ann E. Rogers, PhD, RN Professor, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia. Christine Feeley, PhD, RN Assistant Professor, School of Nursing, University of Pittsburg Medical Center, Pennsylvania. Octavian Ioachimescu, PhD, MD Associate Professor, Atlanta Veterans Affairs Medical Center and Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University, Atlanta, Georgia. Kristina Euwer, MD Medical House Staff, University of Pittsburg Medical Center, Pennsylvania; and School of Medicine, Emory University, Atlanta, Georgia. Danny Eapen, MD Assistant Professor, School of Medicine, Emory University, Atlanta, Georgia. Arshed Quyyumi, MD Professor, School of Medicine, Emory University, Atlanta, Georgia.
Faye S
FS
Routledge
Sandra B
SB
Dunbar
Melinda
M
Higgins
Ann E
AE
Rogers
Christine
C
Feeley
Octavian
O
Ioachimescu
Kristina
K
Euwer
Danny
D
Eapen
Arshed
A
Quyyumi
D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D012044:Regression Analysis; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000503:physiopathology*; D014664:Vasodilation