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Association between cardiovascular health and sleep disturbances: results from two population-based cohort studies, the paris prospective study 3 and the colaus study

Session Poster Session 2

Speaker Jean-Philippe Empana

Event : ESC Preventive Cardiology (Formerly EuroPrevent) 2019

  • Topic : preventive cardiology
  • Sub-topic : Sleep Disorders
  • Session type : Poster Session

Authors : NH Hausler (Lausanne,CH), QL Lisan (Paris,FR), TVS Van Slotten (Maastricht,NL), JHR Haba Rubio (Lausanne,CH), MCP Perier (Paris,FR), FT Thomas (Paris,FR), ND Danchin (Paris,FR), CG Guibout (Paris,FR), PB Boutouyrie (Paris,FR), RH Heinzer (Lausanne,CH), XJ Jouven (Paris,FR), PMV Marques-Vidal (Lausanne,CH), JP Empana (Paris,FR)

NH Hausler1 , QL Lisan2 , TVS Van Slotten3 , JHR Haba Rubio1 , MCP Perier2 , FT Thomas4 , ND Danchin4 , CG Guibout2 , PB Boutouyrie5 , RH Heinzer1 , XJ Jouven2 , PMV Marques-Vidal1 , JP Empana2 , 1University Hospital Centre Vaudois (CHUV), Internal Medicine - Lausanne - Switzerland , 2INSERM U970 Paris Cardiovascular Research Centre - Paris - France , 3Maastricht University Medical Centre (MUMC), Internal Medicine - Maastricht - Netherlands (The) , 4Centre dƒ??Investigations Preventives et Cliniques - Paris - France , 5HÇïpital EuropǸen Georges Pompidou- UniversitǸ Paris Descartes - Paris - France ,


Background: Although cardiovascular risk factors usually cluster, their combined effect on sleep disturbances remains unknown.

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.

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