Abstract 13139: Sleep Duration, Inflammation and Cardiovascular Mortality in Ambulatory Us Adults: Insights From the National Health and Nutrition Examination Survey

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Introduction: Sleep disturbance is associated with higher inflammation and cardiovascular mortality. The interplay between sleep duration and inflammation as an effect modifier for cardiovascular risk is unknown. Hypothesis: We sought to evaluate the association between sleep duration, C-reactive protein (CRP), and cardiovascular mortality. Methods: We used data from the National Health and Nutrition Examination Survey (NHANES) 2005-2010 linked with the cause of death data from the National Center for Health Statistics for adults aged ≥18 years. The associations between short (<6 hours), adequate (6-9 hours), and long (>9 hours) sleep duration with inflammation (CRP) and cardiovascular mortality were explored using linear, Poisson and Cox proportional hazard modeling. Results: There were 17,635 eligible participants. The mean age was 47.5±19.2 years with 51% women and 47% self-identified non-Hispanic Whites. There were 2,755 (15.6%), 14,340 (81.3%), and 540 (3.1%) participants in the short, adequate, and long sleep duration groups, respectively. There were 60 (2.2%), 268 (1.9%), and 22 (4.1%) cardiovascular deaths in the short, adequate, and long sleep duration groups, respectively. The adjusted hazard of cardiovascular mortality was 24% (hazard ratio [HR] 1.24, 95% confidence interval [CI] 1.05-1.47, p=0.012) and 78% (HR 1.78, 95% CI 1.37, 2.30, p<0.001) higher among participants with short and long sleep duration, respectively, compared to adequate sleep duration (Figure, panel A). A similar U-shaped trend was observed between log-transformed CRP with higher CRP among participants with short (b=0.06, p=0.01) and long (b=0.26, p<0.001) sleep duration versus adequate sleep duration (Figure, panel B). Conclusions: Short and long sleep duration are independently associated with a higher hazard of cardiovascular mortality and CRP. These findings suggest an association between circadian rhythm, mortality, and inflammation.