SLEEP DURATION AND ARTERIAL STIFFNESS: A META-ANALYSIS
Pomeroy, Alex Medicine & Science in Sports & Exercise: August 2021 - Volume 53 - Issue 8S - p 78
PURPOSE: Research has shown chronically short (<7 hours) and long (>9 hours) sleep duration may increase cardiovascular disease (CVD) risk relative to recommended sleep duration (7-9 hours). However, the factors contributing to CVD risk that also relate to sleep duration are less understood. One factor could be arterial stiffness (AS), an indicator of CVD risk. This study sought to consolidate the literature examining the association between sleep duration and AS. Studies using pulse wave velocity (PWV), the “gold standard” for AS measurement, were selected for analysis.
METHODS: Electronic databases (PubMed, SPORTDiscus) from inception to July 2020 were referenced. After evaluation of study eligibility, data from 10 cross-sectional studies involving 83,032 participants (65% male) were extracted for meta-analysis. Meta-analyses were completed on 3 sleep duration categories (short, recommended, and long), including sub-group analysis for cardiometabolic (CM) health status, PWV method, and age category (<65 or 65+ y). Outcomes were calculated as weighted mean differences (WMD) using a random-effects model. Standardized mean differences (SMD) were also calculated to determine effect size magnitude, with a SMD of <0.2 as a small effect, 0.2-0.8 as moderate, and > 0.8 as large.
RESULTS: Short sleep resulted in a small but significant increase in PWV (WMD = 15.25 cm/s, 95% confidence intervals (CI): 9.02-21.48 cm/s, p < 0.001, SMD = 0.02). Long sleep resulted in a large and positive increase in PWV (WMD = 33.83 cm/s, 95% CI: 19.87-47.80 cm/s, p < 0.001, SMD = 0.82). Older age had a small moderating effect in short (WMD = 16.8 cm/s, 95% CI: 10.3-23.2 cm/s, p < 0.001, SMD = 0.02) and a large moderating effect in long (WMD = 16.7 cm/s, 95% CI: 10.3-23.2 cm/s, p < 0.001, SMD = 0.95) sleep. CM disease had a small moderating effect in short (WMD = 16.6 cm/s, 95% CI: 10.3-23.0 cm/s, p < 0.001, SMD = 0.03) and a large moderating effect in long (WMD = 26.7 cm/s, 95% CI: 11.7-41.6 cm/s, p < 0.001, SMD = 0.90) sleep.
CONCLUSIONS: Short and long sleep are associated with greater PWV (i.e. increased CVD risk) relative to recommended sleep duration. The effects of short or long sleep on PWV are more pronounced in older adults and adults with a CM disease. These findings indicate arterial stiffness is a factor influencing CVD risk in short and long sleep.