Sleep duration and vascular inflammation using hybrid positron emission tomography/magnetic resonance imaging: results from the Multi-Ethnic Study of Atherosclerosis.

Abstract

Short sleep duration (SD) is associated with cardiovascular disease. We investigated the relationship between objective SD and subclinical atherosclerosis employing hybrid positron emission tomography/magnetic resonance imaging with 18F-FDG tracer in the MESA cohort. We utilized data from Multi-Ethnic Study of Atherosclerosis-SLEEP and Multi-Ethnic Study of Atherosclerosis-PET ancillary studies. SD and sleep fragmentation index (SFI) were assessed using 7-day actigraphy. The primary and secondary outcomes were carotid inflammation, defined using target-to-background ratios, and measures of carotid wall remodeling (carotid wall thickness), summarized by SD category. Multivariable linear regression was performed to assess the association between SD and SFI with the primary/secondary outcomes, adjusting for several covariates including apnea-hypopnea index, and cardiovascular disease risk. Our analytical sample (n = 58) was 62% female (mean age 68 ± 8.4 years). Average SD was 5.1 ± 0.9 hours in the short SD group (≤ 6 h/night, 31%), and 7.1 ± 0.8 hours in the normal SD group (69%). Prevalence of pathologic vascular inflammation (maximal target-to-background ratio > 1.6) was higher in the short SD group (89% vs 53%, P = .01). Those with short SD had a higher maximal target-to-background ratio (1.77 vs 1.71), although this was not statistically significant (P = .39). Carotid wall thickness was positively associated with SFI even after adjusting for covariates (Beta [standard error] = 0.073 ± [0.032], P = .03). Prevalence of pathologic vascular inflammation was higher among those who slept ≤ 6 hours, and vascular inflammation was higher among those with a SD of ≤ 6 hours. Interestingly, SFI was positively associated with carotid wall thickness even after adjustment for covariates. Our results are hypothesis generating but suggest that both habitual SD and SFI should be investigated in future studies as potential risk factors for subclinical atherosclerosis. Kundel V, Reid M, Fayad Z, etal. Sleep duration and vascular inflammation using hybrid positron emission tomography/magnetic resonance imaging: results from the Multi-Ethnic Study of Atherosclerosis. J Clin Sleep Med. 2021;17(10):2009-2018.