%0 Journal Article
%T Self-reported sleep duration and napping, cardiac risk factors and markers of subclinical vascular disease: cross-sectional study in older men
%A Elizabeth A Ellins
%A Julian P J Halcox
%A Lucy Lennon
%A Olia Papacosta
%A Peter H Whincup
%A S Goya Wannamethee
%A Shahrzad Zonoozi
%A Sheena E Ramsay
%J -
%D 2017
%R 10.1136/bmjopen-2017-016396
%X Studyobjectives Daytime sleep has been associated with increased risk of cardiovascular disease and heart failure (HF), but the mechanisms remain unclear. We have investigated the association between daytime and night-time sleep patterns and cardiovascular risk markers in older adults including cardiac markers and subclinical markers of atherosclerosis (arterial stiffness and carotid intima-media thickness (CIMT)).

Methods Cross-sectional study of 1722 surviving men aged 71¨C92 examined in 2010¨C2012 across 24 British towns from a prospective study initiated in 1978¨C1980. Participants completed a questionnaire and were invited for a physical examination. Men with a history of heart attack or HF (n=251) were excluded from the analysis.

Results Self-reported daytime sleep duration was associated with higher fasting glucose and insulin levels (p=0.02£¿and p=0.01, respectively) even after adjustment for age, body mass index, physical activity and social class. Compared with those with no daytime sleep, men with daytime sleep >1£¿hour, defined as excessive daytime sleepiness (EDS), had a higher risk of raised N-terminal pro-brain natriuretic peptide of ¡Ý400£¿pg/mL, the diagnostic threshold for HF (OR (95%£¿CI)=1.88 (1.15 to 3.1)), higher mean troponin, reduced lung function (forced expiratory volume in 1 s) and elevated von Willebrand factor, a marker of endothelial dysfunction. However, EDS was unrelated to CIMT and arterial stiffness. By contrast, night-time sleep was only associated with HbA1c (short or long sleep) and arterial stiffness (short sleep).

Conclusions Daytime sleep duration of >1£¿hour may be an early indicator of HF
%U https://bmjopen.bmj.com/content/7/6/e016396