ASSOCIATION BETWEEN SLEEP COMPLAINTS AND CAROTID ATHEROSCLEROTIC LESIONS

Abstract

Objective: Sleep deprivation is discussed as a cardiovascular risk factor, however, its association with cardiovascular mortality and morbidity is controversial. We assessed the relation between self-reported sleep complaints and carotid atherosclerotic lesions. Design and method: In this analysis, we included 861 (320 males, 37.2%) out of 1600 participants of the St Petersburg population-based sample (within the ESSE-RF study) without previously known cardio/cerebrovascular events. Mean age – 44.9 ± 11.9 years old. Mean body mass index: 26.9 ± 5.3 kg/m2. All participants underwent a structured interview regarding their lifestyle, complaints, medical history, and sleep complaints. In this analysis, we considered the following questions: “How often did you have difficulties in falling asleep for >30 minutes after going to bed in the last month?”, “How often did you have difficulties in falling asleep after midnight awakening in the last month?”. The answers “>1/week” were considered symptomatic. In addition, we measured office blood pressure (BP) and performed a standard duplex ultrasound protocol (My Sono U6, Samsung, Korea) to evaluate carotid intima-media thickness (IMT) (normal: <=0.9 mm, abnormal: 0.91–1.29 mm) and atherosclerotic plaques (local thickening >=1.3 mm). We applied parametric statistics (t-Student, chi-square tests), Spearman correlation analysis. Results: In total, 362 subjects (42%) reported at least one sleep complaint. The atherosclerotic plaques were found in 15 subjects (1.7%). The plaques presence was associated with awakenings (chi-square 9.04, p = 0.005). Abnormal IMT was found in 83 subjects (9.6%). Subjects with sleep-related complaints showed higher IMT values (0.71 ± 0.18 vs. 0.67 ± 0.16 in insomniacs vs. non-insomniacs, p = 0.001). However, there was no association between the rates of sleep complaints and abnormal IMT (p = 0.24). Correlation analysis demonstrated a weak association between mean IMT and sleep complaints (ρ = 0.11, p = 0.001), which disappeared after adjustment for age and BP. Conclusions: In a large epidemiology cohort, we demonstrated an association between sleep complaints and carotid atherosclerosis. However, their role seems to be minor compared to the traditional cardiovascular risk factors, although potential mechanisms and benefits of insomnia treatment deserve further investigation.