Causal Association Between Subtypes of Excessive Daytime Sleepiness and Risk of Cardiovascular Diseases
(2023) In Journal of the American Heart Association 12(24). p.030568-030568- Abstract
BACKGROUND: Excessive daytime sleepiness (EDS), experienced in 10% to 20% of the population, has been associated with cardiovascular disease and death. However, the condition is heterogeneous and is prevalent in individuals having short and long sleep duration. We sought to clarify the relationship between sleep duration subtypes of EDS with cardiovascular outcomes, accounting for these subtypes. METHODS AND RESULTS: We defined 3 sleep duration subtypes of excessive daytime sleepiness: normal (6-9 hours), short (<6 hours), and long (>9 hours), and compared these with a nonsleepy, normal-sleep-duration reference group. We analyzed their associations with incident myocardial infarction (MI) and stroke using medical records of 355... (More)
BACKGROUND: Excessive daytime sleepiness (EDS), experienced in 10% to 20% of the population, has been associated with cardiovascular disease and death. However, the condition is heterogeneous and is prevalent in individuals having short and long sleep duration. We sought to clarify the relationship between sleep duration subtypes of EDS with cardiovascular outcomes, accounting for these subtypes. METHODS AND RESULTS: We defined 3 sleep duration subtypes of excessive daytime sleepiness: normal (6-9 hours), short (<6 hours), and long (>9 hours), and compared these with a nonsleepy, normal-sleep-duration reference group. We analyzed their associations with incident myocardial infarction (MI) and stroke using medical records of 355 901 UK Biobank participants and performed 2-sample Mendelian randomization for each outcome. Compared with healthy sleep, long-sleep EDS was associated with an 83% increased rate of MI (hazard ratio, 1.83 [95% CI, 1.21-2.77]) during 8.2-year median follow-up, adjusting for multiple health and sociodemographic factors. Mendelian randomization analysis provided supporting evidence of a causal role for a genetic long-sleep EDS subtype in MI (inverse-variance weighted β=1.995, P=0.001). In contrast, we did not find evidence that other subtypes of EDS were associated with incident MI or any associations with stroke (P>0.05). CONCLUSIONS: Our study suggests the previous evidence linking EDS with increased cardiovascular disease risk may be primarily driven by the effect of its long-sleep subtype on higher risk of MI. Underlying mechanisms remain to be investigated but may involve sleep irregularity and circadian disruption, suggesting a need for novel interventions in this population.
(Less)
- author
- organization
- publishing date
- 2023-12
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- cardiovascular diseases, excessive daytime sleepiness subtypes, Mendelian randomization, prospective analysis, sleep duration
- in
- Journal of the American Heart Association
- volume
- 12
- issue
- 24
- pages
- 030568 - 030568
- publisher
- Wiley-Blackwell
- external identifiers
-
- pmid:38084713
- scopus:85180418804
- ISSN
- 2047-9980
- DOI
- 10.1161/JAHA.122.030568
- language
- English
- LU publication?
- yes
- id
- 1959934b-fa64-4819-926d-d50b8143be72
- date added to LUP
- 2024-01-03 14:52:22
- date last changed
- 2024-04-18 12:02:00
@article{1959934b-fa64-4819-926d-d50b8143be72,
abstract = {{<p>BACKGROUND: Excessive daytime sleepiness (EDS), experienced in 10% to 20% of the population, has been associated with cardiovascular disease and death. However, the condition is heterogeneous and is prevalent in individuals having short and long sleep duration. We sought to clarify the relationship between sleep duration subtypes of EDS with cardiovascular outcomes, accounting for these subtypes. METHODS AND RESULTS: We defined 3 sleep duration subtypes of excessive daytime sleepiness: normal (6-9 hours), short (<6 hours), and long (>9 hours), and compared these with a nonsleepy, normal-sleep-duration reference group. We analyzed their associations with incident myocardial infarction (MI) and stroke using medical records of 355 901 UK Biobank participants and performed 2-sample Mendelian randomization for each outcome. Compared with healthy sleep, long-sleep EDS was associated with an 83% increased rate of MI (hazard ratio, 1.83 [95% CI, 1.21-2.77]) during 8.2-year median follow-up, adjusting for multiple health and sociodemographic factors. Mendelian randomization analysis provided supporting evidence of a causal role for a genetic long-sleep EDS subtype in MI (inverse-variance weighted β=1.995, P=0.001). In contrast, we did not find evidence that other subtypes of EDS were associated with incident MI or any associations with stroke (P>0.05). CONCLUSIONS: Our study suggests the previous evidence linking EDS with increased cardiovascular disease risk may be primarily driven by the effect of its long-sleep subtype on higher risk of MI. Underlying mechanisms remain to be investigated but may involve sleep irregularity and circadian disruption, suggesting a need for novel interventions in this population.</p>}},
author = {{Goodman, Matthew O. and Dashti, Hassan S. and Lane, Jacqueline M. and Windred, Daniel P. and Burns, Angus and Jones, Samuel E. and Sofer, Tamar and Purcell, Shaun M. and Zhu, Xiaofeng and Ollila, Hanna M. and Kyle, Simon D. and Spiegelhalder, Kai and Peker, Yuksel and Huang, Tianyi and Cain, Sean W. and Phillips, Andrew J.K. and Saxena, Richa and Rutter, Martin K. and Redline, Susan and Wang, Heming}},
issn = {{2047-9980}},
keywords = {{cardiovascular diseases; excessive daytime sleepiness subtypes; Mendelian randomization; prospective analysis; sleep duration}},
language = {{eng}},
number = {{24}},
pages = {{030568--030568}},
publisher = {{Wiley-Blackwell}},
series = {{Journal of the American Heart Association}},
title = {{Causal Association Between Subtypes of Excessive Daytime Sleepiness and Risk of Cardiovascular Diseases}},
url = {{http://dx.doi.org/10.1161/JAHA.122.030568}},
doi = {{10.1161/JAHA.122.030568}},
volume = {{12}},
year = {{2023}},
}