Purpose: We therefore aimed to investigate the association between cardiovascular health (CVH), as defined by the American Heart Association, and several sleep disturbances.
Methods:Two community-based cohorts, the Paris Prospective Study 3 (PPS3, France, n=6,441) and the CoLaus study (Switzerland, n=2,989) were analyzed. Using the 7 metrics of the American Heart Association(nonsmoking; and ideal levels of body mass index, physical activity, diet, blood pressure, fasting blood glucose and total cholesterol), participants with 0-2, 3-4 and 5-7 ideal metrics were categorized as having low, moderate and high CVH. Sleep-disordered breathing (SDB) was evaluated with the Berlin questionnaire (proxy SDB) and SDB severity was measured by polysomnography; excessive daytime sleepiness (EDS) was evaluated with the Epworth scale, whereas insomnia symptoms and short/long sleep duration were extracted from the Pittsburg Sleep Quality index. Associations between each sleep disturbance and global CVH (primary exposure) but also behavioral (nonsmoking; and ideal levels of body mass index, physical activity, diet) and biological (ideal levels of blood pressure, fasting blood glucose and total cholesterol) CVH (secondary exposure) were quantified in multivariable logistic regression analyses and Odds ratio (OR)/relative risk ratio (RRR) together with their 95% confidence intervals (CI) were estimated.
Results: When compared to poor CVH, subjects with intermediate and ideal global CVH had lower odds of proxy for SDB in both cohorts (ORs up to 0.55; 95% CI 0.44-0.68 and 0.35; 95% CI 0.22-0.53, respectively) and had lower SDB severity as defined by the American Academy of Sleep Medicine(RRR up to 0.07; 95% CI 0.02-0.20). Similar associations were found for behavioral and biological CVH. Subjects with intermediate and ideal global CVH had lower odds of EDS in PPS3 (ORs 0.82; 0.72-0.95 and 0.80; 0.82-1.02, respectively). A similar association was found with behavioral CVH in both cohorts. No consistent associations were found between CVH and short/long sleep duration or insomnia symptoms.
Conclusion: Higher levels of CVH, especially behavioral CVH, are associated with lower odds of presenting SDB and EDS.