Article Impact Level: HIGH Data Quality: STRONG Summary of J Epidemiol Community Health. https://doi.org/10.1136/jech-2024-222795 Dr. Jean-Philippe Chaput et al.
Points
- Irregular sleep patterns were significantly associated with a higher risk of major adverse cardiovascular events (MACE), with irregular sleepers showing a 26% increased risk compared to regular sleepers.
- The study found a near-linear association where the risk of MACE decreased as sleep regularity improved, highlighting the importance of consistent sleep patterns.
- Meeting age-specific sleep duration recommendations reduced cardiovascular risk for moderately irregular sleepers but did not eliminate the risk for highly irregular sleepers.
- Even with sufficient sleep duration, individuals with highly irregular sleep patterns continued to face elevated cardiovascular risks, underscoring the critical role of sleep consistency.
- The findings emphasize the need to incorporate sleep regularity into public health guidelines and cardiovascular disease risk assessments alongside traditional sleep duration metrics.
Summary
This study aimed to investigate the relationship between sleep regularity and the risk of major adverse cardiovascular events (MACE) and whether sufficient sleep duration can mitigate the effects of irregular sleep on cardiovascular risk. The study used data from the UK Biobank, analyzing 72,269 adults aged 40-79 who wore wrist accelerometers for seven days. Sleep regularity was quantified using the Sleep Regularity Index (SRI), with scores categorized into three groups: irregular (SRI <71.6), moderately irregular (SRI between 71.6 and 87.3), and regular (SRI >87.3). MACE and its subtypes (myocardial infarction, heart failure, and stroke) were identified through hospitalizations and death records.
Over an 8-year follow-up period, the study found that irregular sleepers had a significantly higher risk of MACE (hazard ratio [HR] 1.26, 95% CI 1.16 to 1.37), and moderately irregular sleepers also faced a higher risk (HR 1.08, 95% CI 1.01 to 1.70) compared to those with regular sleep. A dose-response relationship was observed, with the risk of MACE decreasing as SRI scores increased, showing a near-linear association. When examining the combined effects of sleep regularity and duration, the results indicated that meeting age-specific sleep duration recommendations could offset the risk for moderately irregular sleepers (HR 1.07, 95% CI 0.96 to 1.18). However, this effect was not seen for those with irregular sleep (HR 1.19, 95% CI 1.06 to 1.35).
In conclusion, the study highlighted that irregular sleep is strongly associated with an increased risk of MACE. Moreover, while adequate sleep duration was beneficial, it was not enough to mitigate the adverse cardiovascular effects of irregular sleep. These findings suggest that sleep regularity should be incorporated into public health guidelines and clinical practices as an important cardiovascular disease risk assessment factor.
Link to the article: https://jech.bmj.com/content/early/2024/10/30/jech-2024-222795
References Chaput, J.-P., Biswas, R. K., Ahmadi, M., Cistulli, P. A., Rajaratnam, S. M. W., Bian, W., St-Onge, M.-P., & Stamatakis, E. (2024). Sleep regularity and major adverse cardiovascular events: A device-based prospective study in 72 269 UK adults. J Epidemiol Community Health. https://doi.org/10.1136/jech-2024-222795
