Short Sleep Duration as a Risk Factor for Hypercholesterolemia: Analyses of the National Longitudinal Study of Adolescent Health

James E Gangwisch,Lindsay A Babiss,Sa Shen,J Blake Turner,Kelly Posner,Mark G Opler,Dolores Malaspina,Henry N Ginsberg,Gary K Zammit

doi:10.1093/sleep/33.7.956

Abstract

To explore the relationship between sleep duration in adolescence and hypercholesterolemia in young adulthood. Experimental sleep restriction has been shown to significantly increase total cholesterol and LDL cholesterol levels in women. Short sleep duration has been found in cross sectional studies to be associated with higher total cholesterol and lower HDL cholesterol levels. Sleep deprivation could increase the risk for hypercholesterolemia by increasing appetite and dietary consumption of saturated fats, decreasing motivation to engage in regular physical activity, and increasing stress and resultant catecholamine induced lipolysis. No previous published population studies have examined the longitudinal relationship between sleep duration and high cholesterol. Multivariate longitudinal analyses stratified by sex of the ADD Health using logistic regression. United States nationally representative, school-based, probability-based sample. Adolescents (n = 14,257) in grades 7 to 12 at baseline (1994-95) and ages 18 to 26 at follow-up (2001-02). Among females, each additional hour of sleep was associated with a significantly decreased odds of being diagnosed with high cholesterol in young adulthood (OR = 0.85, 95% CI 0.75-0.96) after controlling for covariates. Additional sleep was associated with decreased, yet not statistically significant, odds ratios for hypercholesterolemia in males (OR = 0.91, 95% CI 0.79-1.05). Short sleep durations in adolescent women could be a significant risk factor for high cholesterol. Interventions that lengthen sleep could potentially serve as treatments and as primary preventative measures for hypercholesterolemia.

Highlights

ATHEROSCLEROSIS IS A DISEASE PROCESS RECOGNIZED TO BEGIN IN THE FIRST DECADES OF LIFE.[1]
We explored whether short sleep durations in adolescence would be associated with increased odds of having been diagnosed with high cholesterol 7 to 8 years later in young adulthood among subjects who participated in the National Longitudinal Study of Adolescent Health (Add Health)
These results were not appreciably attenuated with the inclusion of physical activity/inactivity, emotional distress and body weight in subsequent Models 2, 3, and 4, indicating that these variables did not act as mediators of the relationship between sleep duration and hypercholesterolemia

Summary

Introduction

ATHEROSCLEROSIS IS A DISEASE PROCESS RECOGNIZED TO BEGIN IN THE FIRST DECADES OF LIFE.[1] IDENTIFICATION AND MANAGEMENT OF RISK factors for atherosclerosis can decrease the morbidity and mortality from the disease Evidence from both experimental and population-based studies have implicated short sleep duration in the pathogenesis of obesity,[2,3] diabetes,[4,5] and hypertension,[6,7] all of which are potent risk factors for atherosclerosis. We are not aware of any previous population-based studies on the relationship between sleep duration and high cholesterol that have had longitudinal designs. We explored whether short sleep durations in adolescence would be associated with increased odds of having been diagnosed with high cholesterol 7 to 8 years later in young adulthood among subjects who participated in the National Longitudinal Study of Adolescent Health (Add Health). We theorized that the relationship would be stronger in women than in men given results from previous cross-sectional population based and experimental studies

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Results

Conclusion