Kadoya M, et al. - Researchers assessed the significance of objectively measured sleep quality in patients with regard to progression of arterial stiffness over a 3-year follow-up period. They reported the association of low sleep quality (LSQ) with progression of arterial stiffness over a 3-year period. This link was independent of cardiovascular risk factors such as blood pressure (BP), apnea-hypopnea index (AHI), and heart rate variability (HRV).

Methods

• In this prospective cohort study, a total of 306 serial patients registered in the Hyogo Sleep Cardio-Autonomic Atherosclerosis (HSCAA) study were included.
• Researchers assessed participants for classical cardiovascular risk factors (body mass index, current smoking, past history of cardiovascular disease, dyslipidemia, diabetes mellitus), ambulatory blood pressure (BP), apnea-hypopnea index (AHI), standard deviation of the NN (RR) interval (SDNN) for heart rate variability (HRV), and objective sleep quality using actigraphy findings.
• They measured brachial-ankle pulse wave velocity (baPWV) at both baseline and follow-up (36.6 ± 6.8 months) as a parameter of arterial stiffness.

Results

• In the low sleep quality (LSQ) group (5.75 ± 1.15%) vs normal sleep quality group (2.69 ± 0.85%), greater (p = 0.03) increases in PWV (%) were reported.
• Researchers noted that a significantly (p < 0.05) larger percentage of LSQ (75% vs 49.6%) was demonstrated by patients with the greatest increase (≥20%) from baseline as compared to those without PWV progression (<0%), with the association still significant (odds ratio 3.62, 95% confidence interval 1.04–12.55, p = 0.04) even after adjustment for other clinical risk factors.
• Significant association of diabetes and LSQ with the greatest increase of PWV was indicated for all subjects in univariate logistic regression analyses.
• Additionally, more prominent associations of LSQ with the greatest increase of PWV in patients with greater age, dyslipidemia, and higher AHI was revealed through comparisons of characteristics among specific subgroups.