Relationship Between Sleep Quality, Sleep Disturbance, and Estimated Cardiovascular Risk

Abstract

Background: Sleep quality and disturbances have been suggested to play an important role in cardiovascular disease risk. Objective(s): The aim of the present study is to investigate the possible relationship between quality of sleep, sleep disturbances, and cardiovascular disease risk in adults. Methods: This cross-sectional study was conducted in the Family Medicine Outpatient Clinic at Cairo University, Kasr Alainy Hospital. The participants of this study were 124 adults who were subjected to be interviewed with sleep questionnaires, including the Pittsburgh Sleep Quality Index, Epworth Sleepiness scale, Berlin Questionnaire, and Restless Legs Syndrome Rating Scale. Their blood pressure and body mass index were measured, along with the fasting blood glucose and lipid profile assessment. Moreover, atherosclerotic cardiovascular disease (ASCVD) risk was calculated. The participants were then classified into two groups according to their estimated risk of ASCVD: low- or borderline-risk group and intermediate- or high-risk group. Results: In both groups, the comparison of the results of the Pittsburgh Sleep Quality Index (PSQI) showed a significant difference: total score (about 40% of bad sleepers and 20% of good sleepers had intermediate to high ASCVD risk), subjective sleep quality, sleep efficiency, and the use of sleep medications (p values = 0.015, 0.023, and 0.023, respectively). Moderate positive correlations were observed between the ASCVD risk score and total PSQI score (r = 0.4, p < 0.001), subjective sleep (r = 0.332, p < 0.001), sleep latency (r = 0.3, p = 0.006), sleep duration (r = 0.4, p < 0.001), sleep efficiency (r = 0.4, p = 0.001), sleep disturbance (r = 0.218, p = 0.016), and the use of sleep medications (r = 0.24, p = 0.002). In both groups, a significant difference was observed in the severity of restless legs syndrome (p value = 0.012). Conclusion: Based on the results of the study, the overall sleep quality was linked to a higher estimated risk of developing cardiovascular events. A significant positive moderate correlation was found between sleep quality scores and cardiovascular risk, especially sleep efficiency and duration.