Habitual Short Sleep Duration Research Articles

Habitual Short Sleep Duration, Diet, and Development of Type 2 Diabetes in Adults

Understanding the interplay between sleep duration, dietary habits, and the risk of developing type 2 diabetes (T2D) is crucial for public health and diabetes prevention strategies. To investigate the associations of type of diet and duration of sleep with the development of T2D. Data derived from the UK Biobank baseline investigation (2006-2010) were analyzed for this cohort study between May 1 and September 30, 2023. The association between sleep duration and healthy dietary patterns with the risk of T2D was investigated during a median (IQR) follow-up of 12.5 (11.8-13.2) years (end of follow-up, September 30, 2021). For the analysis, 247 867 participants were categorized into 4 sleep duration groups: normal (7-8 hours per day), mild short (6 hours per day), moderate short (5 hours per day), and extreme short (3-4 hours per day). Their dietary habits were evaluated based on population-specific consumption of red meat, processed meat, fruits, vegetables, and fish, resulting in a healthy diet score ranging from 0 (unhealthiest) to 5 (healthiest). Cox proportional hazards regression analysis was used to calculate hazard ratios (HRs) and 95% CIs for the development of T2D across various sleep duration groups and healthy diet scores. The cohort comprised 247 867 participants with a mean [SD] age of 55.9 [8.1] years, of whom 52.3% were female. During the follow-up, 3.2% of participants were diagnosed with T2D based on hospital registry data. Cox regression analysis, adjusted for confounding variables, indicated a significant increase in the risk of T2D among participants with 5 hours or less of daily sleep. Individuals sleeping 5 hours per day exhibited a 1.16 adjusted HR (95% CI, 1.05-1.28), and individuals sleeping 3 to 4 hours per day exhibited a 1.41 adjusted HR (95% CI, 1.19-1.68) compared with individuals with normal sleep duration. Furthermore, individuals with the healthiest dietary patterns had a reduced risk of T2D (HR, 0.75 [95% CI, 0.63-0.88]). The association between short sleep duration and increased risk of T2D persisted even for individuals following a healthy diet, but there was no multiplicative interaction between sleep duration and healthy diet score. In this cohort study involving UK residents, habitual short sleep duration was associated with increased risk of developing T2D. This association persisted even among participants who maintained a healthy diet. To validate these findings, further longitudinal studies are needed, incorporating repeated measures of sleep (including objective assessments) and dietary habits.

Biomarkers linking habitual short sleep duration with risk of cardiometabolic disease: current progress and future directions

Approximately one in three adults in the United States sleeps less than the recommended 7 h per night. Decades of epidemiological data and data from experimental sleep restriction studies demonstrate short sleep duration is associated with adverse cardiometabolic risk, including risk of type 2 diabetes and cardiovascular disease. However, the precise mechanisms underlying this risk are not fully elucidated and there is a lack of sleep-based interventions designed to mitigate such risk. One strategy to overcome these limitations is to develop biomarkers that link habitual short sleep duration with adverse cardiometabolic risk. Such biomarkers could inform biochemical mechanisms, identify new targets for interventions, support precision medicine by identifying individuals most likely to benefit from sleep-based interventions, and ultimately lead to improved cardiometabolic health in people with habitual short sleep durations. Early progress demonstrates proof-of-principle that omics-based technologies are a viable approach to create biochemical signatures (biomarkers) of short sleep duration, primarily derived from acute studies of experimental sleep restriction. Yet, much work remains. Notably, studies that translate early findings from experimental sleep restriction to free-living adults with habitual short sleep duration have high potential to advance the field. Such studies also create an exciting opportunity for larger randomized controlled trials that simultaneously identify biomarkers of habitual short sleep duration and evaluate the efficacy of sleep-based interventions. Ultimately, early progress in developing molecular biomarkers of short sleep duration combined with the prior decades of progress in the sleep and metabolism fields provide the foundation for exciting progress in the biomarker development space.

The effect of sleep extension on metabolic and androgen parameters of healthy women with habitual short sleep duration: Pilot study

The effect of sleep extension on metabolic and androgen parameters of healthy women with habitual short sleep duration: Pilot study

Habitual short sleepers with pre-existing medical conditions are at higher risk of Long COVID.

Preliminary evidence suggests that the risk of Long COVID is higher among people with pre-existing medical conditions. Based on its proven adjuvant role in immunity, habitual sleep duration may alter the risk of developing Long COVID. The objective of this study was to determine whether the odds of Long COVID are higher among those with pre-existing medical conditions, and whether the strength of this association varies by habitual sleep duration. Using data from 13,461 respondents from 16 countries who participated in the 2021 survey-based International COVID Sleep Study II (ICOSS II), we studied the associations between habitual sleep duration, pre-existing medical conditions, and Long COVID. Of 2,508 individuals who had COVID-19, 61% reported at least 1 Long COVID symptom. Multivariable logistic regression analysis showed that the risk of having Long COVID was 1.8-fold higher for average-length sleepers (6-9 h/night) with pre-existing medical conditions compared with those without pre-existing medical conditions (adjusted odds ratio [aOR] 1.84 [1.18-2.90]; P = .008). The risk of Long COVID was 3-fold higher for short sleepers with pre-existing medical conditions (aOR 2.95 [1.04-8.4]; P = .043) and not significantly higher for long sleepers with pre-existing conditions (aOR 2.11 [0.93-4.77]; P = .073) compared with average-length sleepers without pre-existing conditions. Habitual short nighttime sleep duration exacerbated the risk of Long COVID in individuals with pre-existing conditions. Restoring nighttime sleep to average duration represents a potentially modifiable behavioral factor to lower the odds of Long COVID for at-risk patients. Berezin L, Waseem R, Merikanto I, etal. Habitual short sleepers with pre-existing medical conditions are at higher risk of long COVID. J Clin Sleep Med. 2024;20(1):111-119.

Adherence to CPAP in summer to autumn predicts self-reported common cold symptoms in patients with obstructive sleep apnea in winter: A prospective observational study

ObjectiveWe conducted a prospective observational study to determine the relationship between adherence to continuous positive airway pressure (CPAP) and susceptibility to the common cold in moderate-to-severe obstructive sleep apnea (OSA) patients. MethodsWe prospectively investigated the number of days with common cold symptoms from November 2019 to February 2020. The rate of CPAP use for 4 h/night in the preceding four months (July to October 2019) was used as a measure of CPAP adherence. Multiple generalized linear models were used to evaluate the association to days of common cold symptoms after controlling for demographic variables, habitual short sleep duration, and insomnia severity. ResultsWe included 123 outpatients (median age 63 years) with moderate-to-severe OSA treated with CPAP. In the multivariate generalized linear model, better CPAP adherence was independently significantly associated with days with fewer common cold symptoms (β = −0.248, P = 0.031); meanwhile, the severity of insomnia and habitual short sleep duration was not significantly associated with it. Subgroup analyses revealed that the association between CPAP adherence and days with common cold symptoms was also significant in young to middle-aged (<65 years) participants (β = −0.407, P = 0.005). In contrast, the association was negligible in older (≥65 years) participants. ConclusionsCPAP adherence may be protective against viral infections in patients with moderate-to-severe OSA. This effect appears to be more pronounced in young to middle-aged patients with OSA.

Sleep duration, plasma metabolites, and obesity and diabetes: a metabolome-wide association study in US women.

Short and long sleep duration are associated with adverse metabolic outcomes, such as obesity and diabetes. We evaluated cross-sectional differences in metabolite levels between women with self-reported habitual short (<7 h), medium (7-8 h), and long (≥9 h) sleep duration to delineate potential underlying biological mechanisms. In total, 210 metabolites were measured via liquid chromatography-mass spectrometry in 9207 women from the Nurses' Health Study (NHS; N = 5027), the NHSII (N = 2368), and the Women's Health Initiative (WHI; N = 2287). Twenty metabolites were consistently (i.e. praw < .05 in ≥2 cohorts) and/or strongly (pFDR < .05 in at least one cohort) associated with short sleep duration after multi-variable adjustment. Specifically, levels of two lysophosphatidylethanolamines, four lysophosphatidylcholines, hydroxyproline and phenylacetylglutamine were higher compared to medium sleep duration, while levels of one diacylglycerol and eleven triacylglycerols (TAGs; all with ≥3 double bonds) were lower. Moreover, enrichment analysis assessing associations of metabolites with short sleep based on biological categories demonstrated significantly increased acylcarnitine levels for short sleep. A metabolite score for short sleep duration based on 12 LASSO-regression selected metabolites was not significantly associated with prevalent and incident obesity and diabetes. Associations of single metabolites with long sleep duration were less robust. However, enrichment analysis demonstrated significant enrichment scores for four lipid classes, all of which (most markedly TAGs) were of opposite sign than the scores for short sleep. Habitual short sleep exhibits a signature on the human plasma metabolome which is different from medium and long sleep. However, we could not detect a direct link of this signature with obesity and diabetes risk.

Associations Between Sleep Health and Amygdala Reactivity to Negative Facial Expressions in the UK Biobank Cohort

BackgroundSleep health (SH) is considered a key determinant of human physiological and psychological well-being. In line with this, previous studies have found that poor sleep is associated with various psychiatric disorders, in particular, with anxiety and depression. Although little is known about the neural mechanisms underlying these associations, recent findings suggest that essential dimensions of SH are associated with altered amygdala reactivity (AR); however, evidence to date is inconsistent and reliant on small sample sizes. MethodsTo address this problem, the current preregistered study investigated associations between SH and AR to negative facial expressions in the UK Biobank cohort (25,758 participants). Drawing on a large sample size and consistent data acquisition, 5 dimensions of SH (insomnia symptoms, sleep duration, daytime sleepiness, chronotype, and sleep medication) were examined. ResultsExploratory analyses revealed that short sleep duration was associated with decreased AR. The remaining SH dimensions and a composite measure of all SH dimensions were not associated with AR. ConclusionsTo our knowledge, this is the largest study to test associations between SH and AR. Habitual short sleep duration may be associated with decreased AR, possibly indicating compensation for impaired prefrontal processes and hampered emotion regulation.

Objectively Assessed Habitual Sleep Duration Is Associated with Peripheral and Central Blood Pressure in Non‐Hypertensive Young Adults

Habitual short sleep duration (&lt;6 hrs/night) has been reliably shown to predict higher blood pressure (BP) and hypertension in adults. However, most studies evaluating this association in free‐living adults (i.e., non‐experimental settings) have: 1. relied on subjective sleep duration estimates or actigraphy‐derived estimates spanning ≤7 days; 2. failed to consider central BP, which has been reported to provide greater insight into future cardiovascular risk as compared to peripheral BP; and 3. neglected to consider the influence of sleep duration the night prior to BP evaluation despite evidence that episodes of acute sleep loss (e.g., experimentally shortened sleep duration) increases peripheral BP values in young adults. Therefore, the purpose of the present study was to investigate the association between objectively measured habitual sleep duration (HSD) with peripheral and central BP in non‐hypertensive, non‐shift working, apparently healthy, young adults free of sleep disorders. This study also examined whether changes in sleep duration the night before BP measurement (ΔSD) influenced these relationships. We hypothesized that shorter HSD would significantly predict higher peripheral and central BP values, but that the association would be weakened after adjusting for ΔSD the night before assessment. Sleep duration (the total time scored as sleep between sleep onset and offset) was measured via wrist‐worn actigraphy for 14 consecutive nights (days 1‐14) and mean HSD was generated. Additionally, ΔSD was calculated as the difference between sleep duration the night before testing (day 14) and mean sleep duration across days 1‐13. On the morning following the final night of sleep monitoring (day 15), resting supine peripheral BP was measured, and central BP was estimated using pulse wave analysis. BP measures included systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP). The associations between HSD and peripheral and central BP values were evaluated using linear regression models of BP values. Regression models were further adjusted for ΔSD to determine whether this influenced these associations. The analytic sample consisted of 28 participants (11M/17F; 27±7 yrs). Mean HSD for the sample was 6.91±0.74 hours per night. ΔSD sleep was ‐25±53 minutes, indicating that on average, sleep duration was shorter the night before testing. Shorter mean HSD significantly predicted both higher peripheral BP (SPB: β= ‐6.44, SE= 2.11, p&lt; 0.01; DBP: β= ‐5.03, SE= 1.63, p&lt; 0.01; MAP: β= ‐5.42, SE= 1.63, p&lt; 0.01) and higher central BP (cSBP: β= ‐5.79, SE= 2.00, p&lt; 0.01; cDBP: β= ‐5.06, SE= 1.59, p&lt; 0.01; cMAP: β= ‐5.45, SE= 1.74, p&lt; 0.01) values. When models were adjusted for ΔSD, HSD remained a significant predictor of peripheral BP (SPB: β= ‐5.45, SE= 2.06, p= 0.01; DBP: β= ‐4.50, SE= 1.66, p= 0.01; MAP: β= ‐4.71, SE= 1.60, p= 0.01) and central BP (cSBP: β= ‐4.91, SE= 2.00, p= 0.02; cDBP: β= ‐4.57, SE= 1.62, p= 0.01; cMAP: β= ‐4.81, SE= 1.75, p= 0.01). Our findings support prior evidence that HSD plays a key role in peripheral BP regulation and newly demonstrate that HSD is also significantly inversely associated with central BP values. Acute alterations in sleep duration the night prior to BP evaluation has a minimal influence on the association between HSD and BP in young, otherwise healthy free‐living adults.

Individual differences in habitual short sleep duration and dysfunction: Subjective health versus objective cardiovascular disease risk.

The adverse health effects of short sleep duration (i.e., six or fewer hours per night) are well established, including an increased risk of cardiovascular disease (CVD) and related mortality. However, there is heterogeneity in perceived sleep need among habitual short sleepers (HSS), with a sizable minority reporting no sleep-related daytime dysfunction. It has not been determined whether health risk associated with short sleep duration is consistent across individuals with and without reported dysfunction. The current study examined self-rated health (SRH), previously demonstrated to predict CVD risk, and objective CVD risk among HSS with and without reported dysfunction in the National Health and Nutrition Examination Surveys (NHANES). Participants were adults age 40-79 in the 2005-2006 and 2007-2008 NHANES cycles. Assessments included the single item SRH (poor to excellent), self-reported average sleep duration, and self-reported daytime sleep-related dysfunction. Ten-year atherosclerotic CVD and high lifetime CVD risk (≥39%) were calculated using previously validated algorithms. HSS with no reported dysfunction rated their overall health significantly better than those with reported dysfunction; however, the "no dysfunction" HSS group evidenced modestly, though significantly, higher 10-year CVD risk compared with their dysfunction-reporting counterparts. High lifetime CVD risk, including younger adults age 20-39, was slightly higher for persons not reporting dysfunction, with the exception of short sleepers at the highest level of dysfunction who had the highest prevalence of high lifetime risk. Findings suggest that the absence of perceived sleep-related dysfunction does not confer lower CVD risk, despite higher SRH. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

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

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.

Supplemental Material for Individual Differences in Habitual Short Sleep Duration and Dysfunction: Subjective Health Versus Objective Cardiovascular Disease Risk

Supplemental Material for Individual Differences in Habitual Short Sleep Duration and Dysfunction: Subjective Health Versus Objective Cardiovascular Disease Risk

Daily variations in sleep and glucose in adolescents with type 1 diabetes.

We used multilevel models (MLMs) to determine person (between-persons) and day level (within-person) associations between glucose variability indices and sleep characteristics in adolescents with type 1 diabetes (T1D). Adolescents with T1D (Mean age 13.4 ± 1.8 years; 37.8% male; mean HbA1c 8.2 ± 1.2%, 66 mmol/mol) monitored their sleep and glucose patterns concurrently for 3-7 days with a wrist actigraph on their non-dominant wrist and a continuous glucose monitor (CGM) (their own or a provided, blinded CGM). Glucose variability indices included J index, coefficient of variation, low and high blood glucose risk indices (LBGI and HBGI), time in range, and sleep characteristics, including bedtime, wake time, total sleep time, sleep efficiency, wake after sleep onset, awakenings, and sleep fragmentation index. More overall glucose variability was associated within person, more sleep disruptions (more awakenings and more fragmentation) or poorer sleep in our study (earlier wake time or longer wake after sleep onset). Also, more time spent in hypoglycemia <70 mg/dL and a higher LBGI was associated within person with earlier wake time indicating poorer sleep. However, a lower LBGI was associated with a later between-persons wake time. Monitoring over a longer period of time in subsequent studies would allow researchers to determine the within person association between habitual short sleep duration and glucose variability. Providers should regularly assess sleep habits in adolescents as a way to improve glycemic control. Targeting a euglycemic range overnight is also important to promote better sleep and to decrease sleep disruptions.

Sleep, self-management, neurocognitive function, and glycemia in emerging adults with Type 1 diabetes mellitus: A research protocol.

Type 1 Diabetes (T1D) affects 1.6 million Americans, and only 14% of emerging adults ages 18-25 years achieve targets for glycemic control (A1C < 7.0%). Sleep deficiency, including habitual short sleep duration (<6.5 hr total sleep time and high within-person variability in total sleep time), is associated with poorer glycemic control. Emerging adults with T1D have a more pronounced sleep extension on weekends compared with matched controls, consistent with sleep deficiency; however, associations among sleep variability and glycemic control have not been explored in this population. Sleep deficiency may affect the complex higher-order neurocognitive functioning needed for successful diabetes self-management (DSM). We report the protocol for an ongoing study designed to characterize sleep and the associations among sleep deficiency, neurocognitive function, DSM, diabetes quality of life, and glycemia among a sample of 40 emerging adults with T1D. We monitor sleep via wrist-worn actigraphy and glucose via continuous glucose monitoring concurrently over 14 days. We are collecting data on self-report and objective sleep, a 10-min psychomotor vigilance test on a PVT-192 device, a 3-min Trail Making Test on paper, and questionnaires, including twice-daily Pittsburgh sleep diaries using Research Electronic Data Capture (REDCap)TM . Results from this study will be used to support the development and testing of the efficacy of a tailored sleep self-management intervention that may improve total sleep time, sleep variability, neurocognitive function, DSM, glycemic control, and glucose variability among emerging adults with T1D.

1095 Use Of Mobile Devices At Night Associated With Mental Health In Young Adults

Abstract Introduction Mobile technology use in bed is becoming commonplace and associated with habitual short sleep duration. The present study examined whether device use at night was related to mental health. Methods Data from the Sleep and Healthy Activity, Diet, Environment, and Socialization (SHADES) study comes from a community-based sample, which was restricted to N=473 between the ages of 22-29. Device use was assessed as presence in the room at night, any use at night, texting, emailing, browsing the internet, making or receiving calls, and using social media. Participants were also asked how often they are woken by a call/alert from their phone (unplanned), how often they are woken by their phone alarm (planned), and how often they check their phone at night. These were recorded as never, rarely, some nights, almost every night, and every night, and were assessed as an ordinal outcome. Predictors included score on the Patient Health Questionnaire depression scale (PHQ9), GAD7 anxiety scale, Perceived Stress Scale (PSS), and Multidimensional Scale of Perceived Social Support (MSPSS). Ordinal logistic regression analyses were adjusted for age, sex, race/ethnicity, education, and income. Results Depression was associated with texting (oOR=1.03, p=0.025), email (oOR=1.03, p=0.022), internet (oOR=1.05, p=0.003), unplanned awakenings (oOR=1.05, p=0.001), and checking the phone (oOR=1.09, p&amp;lt;0.0005). Anxiety was associated with texting (oOR=1.05, p=0.001), email (oOR=1.05, p=0.001), internet (oOR=1.05, p=0.002), social media (oOR=1.04, p=0.009), unplanned awakenings (oOR=1.06, p&amp;lt;0.0005), planned awakenings (oOR=1.04, p=0.025), and checking the phone (oOR=1.10, p&amp;lt;0.0005). Perceived stress was associated with internet (oOR=1.02, p=0.034), unplanned awakenings (oOR=1.02, p=0.045), and checking (oOR=1.04, p&amp;lt;0.0005). Social support was associated with decreased checking (oOR=0.98, p=0.018). Conclusion Mobile device use at night itself is not associated with mental health, but specific activities may be. Also, those who report more disruptions from the device and more checking of the device also report worse mental health. Relationships might be bidirectional. Support Dr. Grandner is supported by R01MD011600 The SHADES study was funded by R21ES022931

0927 Variations in Sleep and Glucose in Adolescents with Type 1 Diabetes

Abstract Introduction The association between short sleep duration and poorer glycemic control in adolescents ages 10-16 with type 1 diabetes (T1D) is well established. Researchers have used cross-sectional, between-subjects’ methods, with limited focus on the potential intraindividual variation among these variables. The purpose of this analysis was to examine the within person associations between glucose variability indices (J index, low/high blood glucose index, time in range) and sleep characteristics (bedtime, waketime, total sleep time, sleep efficiency, wake after sleep onset [WASO], awakenings, and sleep fragmentation index) in adolescents with T1D. Methods Adolescents monitored their sleep and glucose patterns concurrently for 3-7 days with a wrist actigraph on their non-dominant wrist and either their own continuous glucose monitor (CGM) or a provided blinded CGM. General linear mixed models (GLMM) were used to determine within-person and day level associations. Results The sample included 38 adolescents (M age 13.4±1.8; 37.8% male; M A1C 8.2±1.2%). Average glucose levels were controlled in all GLMMs. Adolescents had earlier waketimes on days when more time was spent in hypoglycemia &amp;lt;70mg/dL (β=-0.15, p&amp;lt;0.001). At the person level, adolescents had greater WASO with more % time spent in severe hypoglycemia &amp;lt;54mg/dL with more severe low blood glucose indices (β=0.35, p&amp;lt;0.01 and β=0.34, p&amp;lt;0.01 respectively). At the daily level, adolescents had greater WASO (β=0.20, p=0.01) and more awakenings (β=0.16, p=0.04) on the days they had more overall glucose variability (J index) and more severe high blood glucose indices (β=0.17, p=0.04), but were less likely to have more % time in hypoglycemia (β=-0.15, p=0.02). Conclusion Glucose variability was positively associated with poor sleep (e.g., WASO and awakenings) in adolescents with T1D both at the daily and intraindividual level. Monitoring over a longer period of time in subsequent studies would allow researchers to determine the within person associations between habitual short sleep duration and glucose variability. Support NINR T32NR0008346 &amp; P20NR014126, Medtronic MiniMed provided CGMs at a discounted rate for the study.

Abstract P545: Insufficient Sleep and Nitric Oxide-Mediated Endothelium-Dependent Vasodilation in Adults With Elevated Blood Pressure

Elevated blood pressure (BP ≥130/80 mmHg) is associated with increased risk for myocardial infarction, heart failure, stroke and vascular disease. Insufficient nightly sleep (&lt;7 h/night) has been linked not only to the etiology of elevated blood pressure but is a prevalent, often ignored, comorbidity. Indeed, short sleep duration is now considered to be a plausible risk factor for elevated blood pressure and a harbinger of increased cardiovascular risk. A high prevalence of insufficient nightly sleep has been reported in adults with elevated blood pressure. The influence of insufficient sleep on endothelial vasodilator function in adults with elevated blood pressure is unknown. We tested the hypotheses that chronic insufficient sleep is associated with diminished nitric oxide (NO)-mediated endothelium-dependent vasodilation in adults with elevated blood pressure. Moreover, the insufficient sleep-related reduction in endothelial vasodilator function is due, at least in part to increased oxidative stress. Thirty-five middle-aged and older adults with elevated blood pressure were studied: 15 with normal nightly sleep duration (11M/4F; age: 58±2 yr; BP: 136/82±1/2 mmHg; sleep: 7.6±0.2 h/night) and 20 with short nightly sleep duration (14M/6F; 58±1 yr; BP: 138/84±1/1 mmHg; sleep: 6.0±0.1 h/night). Forearm blood flow (FBF) responses to intra-arterial infusion of acetylcholine (ACh), in the absence and presence of the endothelial NO synthase inhibitor N G -monomethyl-L-arginine (L-NMMA) and the antioxidant vitamin C were determined by venous occlusion plethysmography. The FBF response to ACh was significantly lower (~20%) in the short sleep (from 3.8±0.2 to 11.0±0.6 ml/100 ml tissue/min) compared with the normal sleep duration group (from 4.2±0.2 to 13.6±0.6 ml/100 ml tissue/min). L-NMMA significantly reduced (~25%) the FBF response to ACh in the normal sleep but not the short sleep group. Vitamin C markedly increased (~35%; P&lt;0.05) the vasodilator response to ACh in short sleepers only. In summary, habitual short sleep duration worsens NO-mediated endothelium-dependent vasodilation in adults with elevated blood pressure. Furthermore, the sleep-related diminishment in endothelial vasodilator function is due, in part, to increased oxidative stress.

Neural reward processing in self-reported short sleepers: examination of gambling task brain activation in the Human Connectome Project database.

Much of what we assume about the effects of short sleep duration on neural reward processing derives from total sleep deprivation studies. Although total sleep deprivation appears rare, habitual short sleep is common: 30% of working US adults report habitually sleeping ≤ 6 hours/night. It remains largely unknown whether habitual short sleepers exhibit similar reward processing brain activation patterns to those observed following total sleep deprivation in prior studies. Therefore, our aim was to test objectively reward processing brain activation patterns associated with self-reported habitual short sleep duration in a large sample. Nine hundred and fifty-two adult participants from the Human Connectome Project database were grouped on reported habitual short (≤6 hours) vs. medium-length (7-9 hours) sleep duration using the Pittsburgh Sleep Quality Index (PSQI). Reward processing brain activation was examined using a gambling task during functional magnetic resonance imaging (fMRI). Subject-level covariates for age, sex, continuous sleep duration, daytime dysfunction, and PSQI total score are provided as supplemental analyses. Brain activation patterns revealed expected reward processing-related activation for age and sex. However, activation for sleep duration, dysfunction, and PSQI score did not correspond to those evident in previous total sleep deprivation studies. Self-reported short sleep duration, perceived sleep-related dysfunction, and sleep quality via PSQI do not appear to be meaningfully associated with activation in well-described regions of the human neurobiological reward circuit. As these findings are counter to prior results using experimental sleep deprivation, future work focused on more direct comparisons between self-reported sleep variables and experimental sleep deprivation appears warranted.

Insufficient sleep is associated with a pro-atherogenic circulating microRNA signature.

What is the central question of the study Is habitual short sleep associated with altered circulating levels of specific inflammation- and vascular-related microRNAs? What is the main finding and its importance? Circulating levels of miR-125a, miR-126 and miR-146a were significantly lower in the short sleep compared with the normal sleep group. Altered circulating profiles of these vascular-related microRNAs have been linked to vascular inflammation, dysfunction and increased cardiovascular disease events. Sleep-related changes in these microRNAs are consistent with, and might play a role in, the aberrant vascular physiology and increased vascular risk associated with short sleep. Habitual short sleep duration (<7 hnight-1 ) is associated with increased morbidity and mortality attributable, in large part, to increased inflammatory burden and endothelial dysfunction. MicroRNAs (miRNAs) play a key role in regulating vascular health, and circulating levels are now recognized to be sensitive and specific biomarkers of cardiovascular function, inflammation and disease. The aim of this study was to determine whether the expression of circulating miR-34a, miR-92a, miR-125a, miR-126, miR-145, miR-146a and miR-150 is disrupted in adults who habitually sleep<7hnight-1 (short sleep). These were chosen based upon their well-established links with vascular inflammation, function and, in turn, cardiovascular risk. Twenty-four adults were studied: 12 with normal nightly sleep duration (six men and six women; age, 55±3 years old; sleep duration, ≥7.0 hnight-1 ) and 12 with short nightly sleep duration (seven men and five women; 55±2 years old; sleep duration,<7 hnight-1 ), and circulating miRNA expression was assayed by RT-PCR. All subjects were non-smokers, normolipidaemic, non-medicated and free of overt cardiovascular disease. Circulating levels of miR-125a (3.07±1.98versus 7.34±5.34a.u.), miR-126 [1.28 (0.42-2.51) versus 1.78 (1.29-4.80)a.u.] and miR-146a [2.55 (1.00-4.80) versus 6.46 (1.50-11.44)a.u.] were significantly lower (∼60, 40 and 60%, respectively) in the short compared with the normal sleep group. However, there were no significant group differences in circulating levels of miR-34a, miR-92a, miR-145 and miR-150. In summary, chronic short sleep is associated with a marked reduction in circulating levels of miR-125a, miR-126 and miR-146a. Dysregulation of these miRNAs might contribute to the increased inflammatory burden and endothelial dysfunction associated with habitual insufficient sleep.

The coupling of short sleep duration and high sleep need predicts riskier decision making

Objective: To examine how risk-related decision making might be associated with habitual sleep variables, including sleep variability, sleep duration and perceived sleep need in young adults cross-sectionally and longitudinally.Design: 166 participants completed a 7-day protocol with sleep and risk-related decision-making measures at baseline (T1) and 12 months later (T2).Results: Habitual short sleep duration (averaging < 6 h nightly) was identified in 11.0% in our sample. After controlling for baseline demographic factors and risk-taking measures, self-reported sleep need at T1 interacted with habitual short sleep in predicting risk taking at follow-up (F8,139=9.575, adjusted R2=.431, p<.001). T1 greater perceived sleep need predicted more risk taking among short sleepers, but decreased risk taking among normal sleepers at T2. Variable sleep timing was cross-sectionally correlated with making more Risky choices at baseline and fewer Safe choices after loss at follow up.Conclusions: Young adults with variable sleep timing and those with short sleep duration coupled with high perceived sleep need were more likely to take risks. The moderating effects of perceived sleep need suggest that individual differences may alter the impact of sleep loss and hence should be measured and accounted for in future studies.

Actigraphy-based sleep characteristics and aortic stiffness: the Multi-Ethnic Study of Atherosclerosis

The study aimed to examine the association between objective estimates of sleep duration and quality and aortic stiffness while accounting for the potential confounding effect of sleep-disordered breathing. Participants were part of the Multi-Ethnic Study of Atherosclerosis Sleep study. Sleep duration and quality were assessed by 7-day wrist actigraphy, sleep-disordered breathing by home polysomnography, and aortic stiffness by magnetic resonance imaging–based aortic pulse wave velocity (aPWV), ascending and descending aorta distensibility. Aortic stiffness of participants with “normal” sleep duration (6-8 hours) were compared with those of “short” (<6 hours) and “long” sleep duration (>8 hours) adjusting for common cardiovascular risk factors and apnea-hypopnea index. The sample consisted of 908 participants (mean age 68.4 ± 9.1 years, 55.3% female). There was a significant linear trend of increased aPWV across short (n = 252), normal (n = 552), and long sleep durations (n = 104) (P for trend = .008). Multivariable analysis showed that people with short sleep duration had 0.94 m/s lower aPWV (95% CI: −1.54, −0.35), compared with those with normal sleep duration. In this ethnically diverse community cohort, habitual short sleep duration as estimated by actigraphy was associated with lower aortic stiffness.