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Endothelial function and sleep: associations of flow‐mediated dilation with perceived sleep quality and rapid eye movement ( REM ) sleep
Author(s) -
Cooper Denise C.,
Ziegler Michael G.,
Milic Milos S.,
AncoliIsrael Sonia,
Mills Paul J.,
Loredo José S.,
Von Känel Roland,
Dimsdale Joel E.
Publication year - 2014
Publication title -
journal of sleep research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.297
H-Index - 117
eISSN - 1365-2869
pISSN - 0962-1105
DOI - 10.1111/jsr.12083
Subject(s) - polysomnography , medicine , slow wave sleep , obstructive sleep apnea , sleep (system call) , body mass index , rapid eye movement sleep , sleep onset , hypopnea , brachial artery , psychology , audiology , cardiology , apnea , blood pressure , eye movement , insomnia , ophthalmology , electroencephalography , psychiatry , computer science , operating system
Summary Endothelial function typically precedes clinical manifestations of cardiovascular disease and provides a potential mechanism for the associations observed between cardiovascular disease and sleep quality. This study examined how subjective and objective indicators of sleep quality relate to endothelial function, as measured by brachial artery flow‐mediated dilation ( FMD ). In a clinical research centre, 100 non‐shift working adults (mean age: 36 years) completed FMD testing and the P ittsburgh S leep Q uality I ndex, along with a polysomnography assessment to obtain the following measures: slow wave sleep, percentage rapid eye movement ( REM ) sleep, REM sleep latency, total arousal index, total sleep time, wake after sleep onset, sleep efficiency and apnea–hypopnea index. Bivariate correlations and follow‐up multiple regressions examined how FMD related to subjective (i.e. P ittsburgh S leep Q uality I ndex scores) and objective (i.e. polysomnography‐derived) indicators of sleep quality. After FMD showed bivariate correlations with P ittsburgh S leep Q uality I ndex scores, percentage REM sleep and REM latency, further examination with separate regression models indicated that these associations remained significant after adjustments for sex, age, race, hypertension, body mass index, apnea–hypopnea index, smoking and income ( P s < 0.05). Specifically, as FMD decreased, scores on the P ittsburgh S leep Q uality I ndex increased (indicating decreased subjective sleep quality) and percentage REM sleep decreased, while REM sleep latency increased ( P s < 0.05). Poorer subjective sleep quality and adverse changes in REM sleep were associated with diminished vasodilation, which could link sleep disturbances to cardiovascular disease.