Abstract 19123: Associations Between Multiple Dimensions of Poor Sleep and Life’s Essential 8 Cardiovascular Health Score During the Menopausal Transition: Findings From the AHA Research Goes Red Weight Study

Abstract

Introduction: The sleep health metric in AHA Life’s Essential 8 (LE8), a measurement of cardiovascular health (CVH), consists only of sleep duration. Associations of other dimensions of sleep health including sleep quality with the LE8 CVH and its individual components have not yet been evaluated. Methods: Participants were 291 women (n=98 pre-, n=94 peri-, n=99 post-menopausal, mean age=50 ± 3.2yr) between 45-55y from the AHA Research Goes Red Weight Study, which utilized Verily’s online platform. Standardized questionnaires included the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Berlin questionnaire for risk of obstructive sleep apnea (OSA), and a 1-wk NIH ASA 24-Hour Dietary Assessment. The LE8 CVH and component scores were computed. Cross-sectional associations between sleep and overall CVH scores and individual metrics were tested using multivariable logistic regression models adjusted for age, race/ethnicity, education, employment, insurance, and menopausal status. Results: Half of women slept <7 hours/night, 79% reported poor sleep quality (PSQI≥5), one-third had high-risk OSA phenotype, 51% reported insomnia symptoms (ISI≥8), and 12% had evening chronotype. Compared to pre-menopausal women (67%), significantly more post-(83%) and peri-menopausal (86%) women reported poor sleep quality (p<0.01). Women with poor sleep quality had 3-fold higher odds of poor overall CVH score (p=.04). Women with high-risk OSA phenotype and evening chronotype also had ~3-fold higher risk of poor overall CVH scores (OR=3.58, CI=1.79-7.18, and OR=3.33, CI=1.45-7.69, respectively). Poor sleep quality was associated with greater odds of low score on the diet component (OR=2.97, CI=1.55-5.69). Insomnia symptoms were associated with poor score on the BMI component (OR=1.92, CI=1.15-3.21). High-risk OSA phenotype was associated with greater odds of poor scores on the blood pressure, blood glucose, and BMI components (OR=2.3, CI=1.2-4.3; OR=3.2, CI=1.5-7.1, and OR=11.6, CI=6.2-21.6). Conclusions: Multiple aspects of sleep other than duration were associated with overall LE8 CVH score, and individual metrics, among women across menopause. Findings support potential incorporation of sleep quality into CVH constructs.