Exploring the relationship between sleep characteristics and cardiovascular biomarkers among adults aged 46-85 years measured in the Doetinchem cohort study

Abstract

We examined the associations between sleep characteristics and cardiovascular biomarkers among middle-aged and older adults from the general population and explored interactions by age and sex. Cross-sectional data from wave 6 (2013-2017) of the Doetinchem Cohort Study were used, including 3,437 adults aged 46-85 years. Sleep characteristics were measured with the Medical Outcomes Study Sleep Scale (MOS-SS). Sleep duration was categorized into short/moderate/long; sleep quality was expressed on a scale between 0 and 100 with higher scores reflecting poorer sleep quality (sleep disturbance, shortness of breath or headache, sleep adequacy, somnolence, snoring). Multivariable linear regression analyses were performed to assess the association between sleep characteristics with cardiovascular biomarkers (Body Mass Index (BMI), mean arterial pressure, cholesterol ratio). Effect-modification by sex and age was examined. Associations were adjusted for age, sex, educational level, cigarette smoking, alcohol consumption, physical activity and the other biomarkers. Almost all unhealthy sleep characteristics were associated with higher BMI, e.g. somnolence (β = 0.023, 95%CI: 0.014-0.031) and short sleep duration (β = 0.723, 95%CI: 0.154-1.291). The association of snoring with BMI was stronger for women (β = 0.044, 95%CI: 0.035-0.053). A higher cholesterol ratio was associated with somnolence and snoring (in particular age group 65-85 years). For hypertension no associations were found with one exception: somnolence was associated with lower mean arterial pressure. Unhealthy sleep characteristics seem predominantly associated with a higher BMI. More research is needed into the mechanisms underlying the associations between sleep characteristics and cardiovascular biomarkers.