Journal article
Sleep Duration, Insomnia, and Coronary Heart Disease Among Postmenopausal Women in the Women's Health Initiative
Journal of women's health (Larchmont, N.Y. 2002), Vol.22(6), pp.477-486
06/01/2013
DOI: 10.1089/jwh.2012.3918
PMID: 23651054
Abstract
Background:
Long and short sleep duration are associated with increased risk for coronary heart disease (CHD) and cardiovascular disease (CVD); however, evidence is inconsistent. We sought to identify whether self-reported sleep duration and insomnia, based on a validated questionnaire, are associated with increased incident CHD and CVD among postmenopausal women.
Methods:
Women's Health Initiative Observational Study Participants (N=86,329; 50–79 years) who reported on sleep at baseline were followed for incident CVD events. Associations of sleep duration and insomnia with incident CHD and CVD were evaluated using Cox proportional hazards models over 10.3 years.
Results:
Women with high insomnia scores had elevated risk of CHD (38%) and CVD (27%) after adjustment for age and race, and in fully adjusted models (hazard ratio [HR]=1.19, 95% confidence interval [CI] 1.09–1.30; 1.11 95% CI 1.03–2.00). Shorter (≤5 hours) and longer (≥10 hours) sleep duration demonstrated significantly higher incident CHD (25%) and CVD (19%) in age- and race-adjusted models, but this was not significant in fully adjusted models. Formal tests for interaction indicated significant interactions between sleep duration and insomnia for risk of CHD (
p
<0.01) and CVD (
p
=0.02). Women with high insomnia scores and long sleep demonstrated the greatest risk of incident CHD compared to midrange sleep duration (HR=1.93, 95% CI 1.06—3.51) in fully adjusted models.
Conclusions:
Sleep duration and insomnia are associated with CHD and CVD risk, and may interact to cause almost double the risk of CHD and CVD. Additional research is needed to understand how sleep quality modifies the association between prolonged sleep and cardiovascular outcomes.
Details
- Title: Subtitle
- Sleep Duration, Insomnia, and Coronary Heart Disease Among Postmenopausal Women in the Women's Health Initiative
- Creators
- Megan Sands-Lincoln - 2Department of Epidemiology, Program in Public Health, Brown University, Providence, Rhode IslandEric B Loucks - 2Department of Epidemiology, Program in Public Health, Brown University, Providence, Rhode IslandBing Lu - 4Brigham and Women's Hospital, Harvard Medical School, Boston, MassachusettsMary A Carskadon - 6Department of Psychiatry and Human Behavior, Brown University Alpert Medical School, Providence, RIKatherine Sharkey - 7Department of Medicine, Rhode Island Hospital, Providence, RIMarcia L Stefanick - 8Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CaliforniaJudith Ockene - 9Department of Medicine, University of Massachusetts, Worcester, Worcester, MassachusettsNeomi Shah - 10Department of Medicine, Montefiore and Albert Einstein College of Medicine, New York, New YorkKristen G Hairston - 11Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North CarolinaJennifer G Robinson - 12Department of Epidemiology and Medicine, University of Iowa, Iowa City, IowaMarian Limacher - 13Department of Medicine, University of Florida, Gainesville, FloridaLauren Hale - 14Department of Preventive Medicine, State University of New York, Stony Brook, New YorkCharles B Eaton - 3Department of Family Medicine, Brown University Alpert Medical School, Providence, Rhode Island
- Resource Type
- Journal article
- Publication Details
- Journal of women's health (Larchmont, N.Y. 2002), Vol.22(6), pp.477-486
- DOI
- 10.1089/jwh.2012.3918
- PMID
- 23651054
- NLM abbreviation
- J Womens Health (Larchmt)
- ISSN
- 1540-9996
- eISSN
- 1931-843X
- Publisher
- Mary Ann Liebert, Inc
- Language
- English
- Date published
- 06/01/2013
- Academic Unit
- Epidemiology; Internal Medicine
- Record Identifier
- 9983995020802771
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