Sleeping less than five hours each night is associated with a 74 percent increased risk of developing peripheral artery disease (PAD) compared to sleeping seven to eight hours, according to research published in the European Heart Journal – Open, ESC journal. “Our study suggests that sleeping seven to eight hours a night is a good habit to reduce the risk of PAD,” said study author Dr. Shuai Yuan of the Karolinska Institute in Stockholm, Sweden.
More than 200 million people worldwide have peripheral arterial disease (PAD), where arteries in the legs are blocked, restricting blood flow and increasing the risk of stroke and heart attack. Dr. Yuan said: “Insufficient sleep at night and sleep earlier in the day are associated with an increased risk of coronary artery disease that is caused by blockage of arteries similar to PAD. In addition, sleep problems are one of the top complaints in PAD patients. There are limited data on the effect, and our study aims to fill that gap.”
The study involved more than 650,000 participants and was conducted in two parts. First, the researchers analyzed the association of sleep duration and daytime napping with the risk of PAD. In the second part, the researchers used genetic data to perform naturally randomized controlled trials—called Mendelian randomization—to examine the causality of the associations.
Dr. Yuan said: “Observational analyzes are limited by inverse factors – this means that if an association between sleep habits and PAD is found, we cannot be sure whether the sleep habits caused the PAD or the sleep habits caused the PAD. Mendelian randomisation is a robust method. to assess causation and provide more certainty about outcomes.”
Taken together, the strongest evidence was for short sleep, where the association with PAD went both ways. In an observational analysis of 53,416 adults, sleeping less than five hours a night was associated with a nearly doubled risk of PAD compared with seven to eight hours (hazard ratio). [HR] 1.74; 95 percent confidence interval [CI] 1.31-2.31). This finding was supported by further analysis in 156,582 and 452,028 individuals. In causal studies, short sleep was associated with an increased risk of PAD and, in addition, PAD was associated with an increased likelihood of short sleep. Dr. Yuan said: “The results indicate that a short night’s sleep may increase the likelihood of developing PAD, and PAD increases the risk of insufficient sleep.”
Regarding long sleep, in an observational analysis of 53,416 adults, sleeping eight hours or more per night was associated with a 24 percent higher risk of PAD than seven to eight hours (HR 1.24; 95 percent CI 1.08-1.43). This finding was supported by analyzes in two large populations of 156,582 and 452,028 individuals. However, no causal relationship was found between prolonged sleep and PAD. Similar results were reported for sleepers, where there was a 32 percent higher risk of PAD compared to daytime bathers (HR 1.32; 95 per centCI 1.18–1.49) but no causal links were found. “More studies are needed on the relationship between long night sleep, daytime sleepiness and PAD,” said Dr Yuan. “Although we found associations in observational studies, we could not confirm causation.”
He concluded: “More research is needed on how to disrupt the bidirectional link between short sleep and PAD. Lifestyle changes that help people get more sleep, such as being physically active, may reduce the risk of developing PAD. For patients with PAD , adaptive pain management can enable them to get a good night’s sleep.”
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