![]() 27 The MESA (Multi‐Ethnic Study of Atherosclerosis) includes objectively measured sleep data and numerous noninvasive measures of subclinical atherosclerosis, assessed in a diverse sample of older adults. It remains unknown whether irregularity in sleep durations and timing plays a role in the development of atherosclerosis. 21, 22, 23 However, recent evidence has connected irregular sleep patterns to cardiovascular health in the general population. 18, 19, 20 Initial studies on regularity of sleep patterns and CVD risk were focused on nurses and shift workers with pronounced variations in sleep schedules. Irregular sleep patterns and night‐to‐night variations in sleep timing may be indicators of circadian misalignment, or desynchronization of sleep–wake timing, which has been linked to cardiometabolic risk factors. ![]() 8, 9, 10, 11, 12 There is a consistent line of cross‐sectional 13, 14, 15 and prospective 14, 16 evidence to suggest adults with abnormal sleep characteristics are more likely to have significant subclinical atherosclerosis.Īn emerging area of interest is whether sleep irregularity, estimated by variation in sleep durations and sleep timing across nights, 1, 17 is associated with CVD risk. 1 To explore mechanisms through which poor sleep may lead to CVD development, researchers have examined associations of various dimensions of sleep with noninvasive measures of atherosclerosis, which have shown to be strongly associated with incident CVD. 1, 2, 3, 4, 5, 6 Questions remain about which dimensions of sleep may drive the pathophysiologic development of CVD 7 and be promising intervention targets for improving cardiovascular health. Poor sleep, including poor quality, abnormal quantity, and fragmented sleep, is associated with cardiovascular risk factors, incident cardiovascular disease (CVD), and CVD‐related mortality. Associations persisted after adjustment for cardiovascular disease risk factors and average sleep duration, obstructive sleep apnea, and sleep fragmentation.Įncouraging regular sleep schedules may be an important part of clinical lifestyle recommendations for the prevention of cardiovascular disease. After adjustment, compared with participants with more regular sleep durations (SD ≤60 minutes), participants with greater sleep duration irregularity (SD >120 minutes) were more likely to have high coronary artery calcium burden (>300 prevalence ratio, 1.33 ) and abnormal ankle‐brachial index (90 minutes) were more likely to have high coronary artery calcium burden (prevalence ratio, 1.39 ). Models are adjusted for demographics, cardiovascular disease risk factors, and other objectively assessed sleep characteristics including obstructive sleep apnea, sleep duration, and sleep fragmentation. Relative risk regression models were used to calculate prevalence ratios and 95% CIs. Sleep regularity was quantified by the 7‐day with‐in person SD of sleep duration and sleep onset timing. Participants underwent assessments of coronary artery calcium, carotid plaque presence, carotid intima‐media thickness, and the ankle‐brachial index. MESA Sleep Ancillary Study participants (N=2032 mean age, 68.6☙.2 years 37.9% White) completed 7‐day wrist actigraphy. Stroke: Vascular and Interventional Neurology. ![]() Journal of the American Heart Association (JAHA).Circ: Cardiovascular Quality & Outcomes.Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB).
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