Background: Short sleep duration is associated with increased cardiovascular disease risk. However, whether sleep debt, a measure of sleep deficiency during the week compared to the weekend, confers increased cardiovascular risk is uncertain. Because sleep disturbances increase with age particularly in women, we examined the relationship between sleep debt and ideal cardiovascular health in older women.
Methods and Results: Sleep debt, was defined as the difference between self-reported total weekday and weekend sleep hours of ≥ 2 hours among women without apparent cardiovascular disease (CVD) and cancer participating in the Women’s Health Study follow-up cohort of female health professionals (N=21,562). The ideal cardiovascular health (ICH) metric consisted of 7 health factors and behaviors as defined by the AHA Strategic 2020 goals including body mass index, smoking, physical activity, diet, blood pressure, total cholesterol and glucose. Mean age was 72.2 ± 6.0 years old. Compared to women who did not have sleep debt, women with sleep debt were more likely to be obese and have hypertension (pall < 0.05). Linear regression models adjusted for age and race/ethnicity revealed that sleep debt was significantly associated with decreased ICH [p ,0.0001; Table 1]. Taking into account cumulative psychological stress, a composite measure of acute (negative/traumatic life events) and chronic stressors (work, work-family spillover, financial, discrimination, relationship and neighborhood) resulted in the largest attenuation of the magnitude of the relationship between sleep debt and ICH.
Conclusion: In this cross-sectional analysis, sleep debt was significantly associated with decreased ideal cardiovascular health, despite taking into account socioeconomic status and psychosocial factors. These results suggest that weekly sleep duration variation, possibly leading to circadian misalignment, might be associated with cardiovascular risk in older women.