Abstract
BackgroundStudies relying on self-reported sleep data suggest that there is an association between short and long sleep duration and less than ideal cardiovascular health. Evidence regarding the feasibility of using digital health devices to measure sleep duration and assess its relationship to ideal cardiovascular health are lacking. The objective of the present study was to utilize digital health devices to record sleep duration and examine the relationship between sleep duration and ideal cardiovascular health.MethodsA total of 307 participants transmitted sleep duration data from digital health devices and answered the Life’s Simple 7 survey instrument to assess ideal cardiovascular health. Sleep duration was defined as adequate (7 to < 9 h per night) or non-adequate (< 7 h and ≥ 9 h).ResultsWe identified three sleep-cardiovascular health phenogroups: resilient (non-adequate sleep and ideal cardiovascular health), uncoupled (adequate sleep and non-ideal cardiovascular health) or concordant (sleep and cardiovascular health metrics were aligned). Participants in the resilient phenogroup (n = 83) had better cardiovascular health factor profiles (blood pressure, blood glucose and cholesterol levels) and behaviors (healthy weight, diet, exercise, smoking) than participants in the concordant (n = 171) and uncoupled (n = 53) phenogroups. This was associated with higher Life’s Simple 7 Health Scores in the resilient phenogroup compared to the concordant and uncoupled phenogroups (7.8 ± 0.8 vs. 7.0 ± 1.4 vs. 5.6 ± 0.7, P < 0.01).ConclusionThis study identified three distinct sleep-ideal cardiovascular health phenogroups and highlights the advantage of incorporating sleep assessments into studies of cardiovascular health. Future studies should focus on the relationship between sleep-cardiovascular phenogroups and clinical outcomes.Clinical Trial Registration Clinicaltrials.gov NCT02958098. Date of registration: November 11, 2016.
Highlights
Studies relying on self-reported sleep data suggest that there is an association between short and long sleep duration and less than ideal cardiovascular health
Demographics Ageb Female (%) Race and ethnicity Asian Black Hispanic White Other Region Northeast South Midwest West Diagnosed with cardiovascular disease (%) Diabetes mellitus (%)b,c Hypertension (%)b Hypercholesterolemia (%)b,c Medications (%) Diabetes mellitusb,c Hypertensiona,b,c Hypercholesterolemiab Smoking status (%) Current Quit < 12 months Quit ≥ 12 months Never Clinical data Weighta,b,c BMIa,b,c Systolic blood pressurea,d Diastolic blood pressured Total cholesterold Blood glucoseb,d Diet Vegetables/dayb Fruit/dayb Fish Whole grainsb,d Sugar-sweetened beverages Avoid prepackaged foods (%) Avoid eating out (%) Avoid salt at home (%) Exercise Moderate exercise Vigorous exercisec LS7 score Smoking score (%)b Poor
Digital device recorded exercise data revealed that individuals in the concordant and uncoupled groups performed more minutes per week of vigorous exercise than they reported. These findings demonstrate that acquiring digital health device recorded sleep duration is feasible in studies of ideal cardiovascular health but is likely to be more reliable than survey data
Summary
Studies relying on self-reported sleep data suggest that there is an association between short and long sleep duration and less than ideal cardiovascular health. Evidence regarding the feasibility of using digital health devices to measure sleep duration and assess its relationship to ideal cardiovascular health are lacking. In 2010, the American Heart Association developed the Life’s Simple 7 survey to assess ideal cardiovascular health [11]. The survey instrument defines ideal cardiovascular health as a composite of 7 modifiable health factors and behaviors, including healthy weight, blood pressure, cholesterol, and blood glucose as well as a healthy diet, absence of tobacco use, and moderate and vigorous exercise [11, 12]. Individuals that have ideal scores for fewer than five of the 7 categories evaluated by the Life’s Simple 7 survey have an increased risk for developing cardiovascular disease [16, 17]
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