Insomnia Symptoms Are Associated With Abnormal Endothelial Function

• Type of Material: Article
• Authors: Faye Routledge, Emory University; Sandra B Dunbar, Emory University; Melinda K Higgins, Emory University; Ann E Rogers, Emory University; Christine Feeley, University of Pittsburgh; Octavian Cosmin Ioachimescu, Emory University; Kristina Euwer, University of Pittsburgh; Danny Eapen, Emory University; Arshed Ali Quyyumi, Emory University
• Language: English
• Date: 2017-01-01
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2016 Wolters Kluwer Health, Inc. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1097/JCN.0000000000000295
• Title of Journal or Parent Work: Journal of Cardiovascular Nursing
• ISSN: 0889-4655
• Volume: 32
• Issue: 1
• Start Page: 78
• End Page: 85
• Grant/Funding Information: The Predictive Health Institute is supported by the National Center for Advancing Translational Sciences of the National Institutes of Health (Award Number UL1TR000454)
• Keywords: Cardiovascular System & Cardiology; BRACHIAL-ARTERY; Life Sciences & Biomedicine; CARDIOVASCULAR-DISEASE; sleep; sleep latency; Science & Technology; endothelium-dependent vasodilation; insomnia; cardiovascular disease; METAANALYSIS; Nursing; RISK; MATCHED NORMAL SLEEPERS; INTERLEUKIN-6; C-REACTIVE PROTEIN; vasodilation; Cardiac & Cardiovascular Systems; PREDICTIVE HEALTH; FLOW-MEDIATED DILATION; ULTRASOUND ASSESSMENT; awakenings
• Research Categories: Biology, Biostatistics; Health Sciences, Medicine and Surgery

Abstract

Background: Insomnia is a prevalent sleep disorder, and it has been increasingly associated with cardiovascular morbidity and mortality. The reasons for this relationship are not completely understood but may involve endothelial dysfunction. In this study, we hypothesized that insomnia symptoms would be associated with reduced endothelial function. Methods: Working adults (n = 496, 67.5% female, 78.6% white, mean age 48.7 [SD, 10.8] years, body mass index 28.2 [SD, 6.7] kg/m 2 , diabetes 5.8%, hypertension 20.0%, hyperlipidemia 17.9%, heart disease 2.6%) enrolled in the Emory-Georgia Tech Predictive Health Institute study completed baseline demographic, clinical, depression (Beck Depression Inventory II), anxiety (General Anxiety Disorder 7), sleep (Pittsburg Sleep Quality Index), and noninvasive endothelial function (brachial artery flow-mediated dilation [FMD]) measures. Insomnia symptoms were defined as subjective sleep latency of 30 minutes or longer, nighttime or early morning awakenings, and/or sleep medication use occurring 3 times or more per week in the past month. Results: Insomnia symptoms were reported by 39.5% of participants. Multivariable regression models showed that insomnia symptoms, age, baseline artery diameter, and dyslipidemia were inversely related to FMD. After adjusting for age, baseline artery diameter, and dyslipidemia, participants reporting insomnia symptoms had lower FMD than did participants reporting better sleep (adjusted FMD mean, 6.13% [SD, 0.28%] vs 6.83% [SD, 0.26%], P =.035). Conclusion: In this study, insomnia symptoms were associated with reduced FMD. Research examining the therapeutic benefits of treating insomnia on endothelial function and future cardiovascular risk is warranted.