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Sleep Quality is associated with Central Arterial Stiffness in Postmenopausal Women: A Cross-sectional Pilot Study

Abstract

This study aimed to investigate the associations between sleep quality and arterial stiffness in healthy postmenopausal women. A total of 31 healthy postmenopausal women aged between 50 and 74 years participated in this study. Objectively and subjectively measured sleep quantity and quality were concomitantly obtained by a waist-worn actigraphy, Pittsburgh Sleep Quality Index (PSQI) questionnaire, and daily sleep diary. Carotid-femoral pulse wave velocity (cfPWV), brachial-ankle PWV (baPWV), and femoral-ankle PWV (faPWV) were measured as indices of arterial stiffness. Based on the PSQI score, the participants were divided into good (PSQI < 5.5; n = 21) and poor (PSQI > 5.5; n = 10) sleepers. Self-reported sleep duration was significantly longer in poor sleepers than in good sleepers. However, there was no difference in total sleep time measured by actigraphy between the two groups. Additionally, sleep latency and wake after sleep onset significantly increased, and sleep efficiency significantly decreased in poor sleepers than in good sleepers. The cfPWV and baPWV were significantly higher in poor sleepers than in good sleepers, even after adjustment for risk factors (i.e., age, blood pressure, and physical activity), but no difference in faPWV. These results suggest that decreased sleep quality is associated with an increase in central arterial stiffness in postmenopausal women.

References

  1. Cappuccio FP, D’Elia L, Strazzullo P, Miller MA. Quantity and quality of sleep and incidence of type 2 diabetes: a systematic review and meta-analysis. Diabetes Care 2010;33:414–20.

    Google Scholar 

  2. Cappuccio FP, Cooper D, D’Elia L, Strazzullo P, Miller MA. Sleep duration predicts cardiovascular outcomes: a systematic review and meta-analysis of prospective studies. Eur Heart J 2011;32:1484–92.

    Google Scholar 

  3. Wilsmore BR, Grunstein RR, Fransen M, Woodward M, Norton R, Ameratunga S. Sleep habits, insomnia, and daytime sleepiness in a large and healthy community-based sample of New Zealanders. J Clin Sleep Med 2013;9:559–66.

    Google Scholar 

  4. Furihata R, Uchiyama M, Takahashi S, Suzuki M, Konno C, Osaki K, et al. The association between sleep problems and perceived health status: a Japanese nationwide general population survey. Sleep Med 2012;13:831–7.

    Google Scholar 

  5. Phillips BA, Collop NA, Drake C, Consens F, Vgontzas AN, Weaver TE. Sleep disorders and medical conditions in wom. Proceedings of the Women & Sleep Workshop, National Sleep Foundation, Washington, DC, March 5-6, 2007. J Womens Health (Larchmt) 2008;17:1191–9.

    Google Scholar 

  6. Sun D, Shao H, Li C, Tao M. Sleep disturbance and correlates in menopausal women in Shanghai. J Psychosom Res 2014;76:237–41.

    Google Scholar 

  7. Young T, Rabago D, Zgierska A, Austin D, Finn L. Objective and subjective sleep quality in premenopausal, perimenopausal, and postmenopausal women in the Wisconsin Sleep Cohort Study. Sleep 2003;26:667–72.

    Google Scholar 

  8. Chair SY, Wang Q, Cheng HY, Lo SWS, Li XM, Wong EML, et al. Relationship between sleep quality and cardiovascular disease risk in Chinese post-menopausal women. BMC Womens Health 2017;17:79.

    Google Scholar 

  9. Mitchell GF, Parise H, Benjamin EJ, Larson MG, Keyes MJ, Vita JA, et al. Changes in arterial stiffness and wave reflection with advancing age in healthy men and women: the Framingham Heart Study. Hypertension 2004;43:1239–45.

    Google Scholar 

  10. Willum-Hansen T, Staessen JA, Torp-Pedersen C, Rasmussen S, Thijs L, Ibsen H, et al. Prognostic value of aortic pulse wave velocity as index of arterial stiffness in the general population. Circulation 2006;113:664–70.

    Google Scholar 

  11. Mitchell GF, Hwang SJ, Vasan RS, Larson MG, Pencina MJ, Hamburg NM, et al. Arterial stiffness and cardiovascular events the Framingham Heart Study. Circulation 2010;121;505–11.

  12. Meaume S, Benetos A, Henry OF, Rudnichi A, Safar ME. Aortic pulse wave velocity predicts cardiovascular mortality in subjects >70 years of age. Arterioscler Thromb Vasc Biol 2001;21:2046–50.

    Google Scholar 

  13. Takahashi K, Miura S, Mori-Abe A, Kawagoe J, Takata K, Ohmichi M, et al. Impact of menopause on the augmentation of arterial stiffness with aging. Gynecol Obstet Inves 2005;60:162–6.

    Google Scholar 

  14. Wolff B, Volzke H, Schwahn C, Robinson D, Kessler C, John U. Relation of self-reported sleep duration with carotid intima-media thickness in a general population sample. Atherosclerosis 2008;196:727–32.

  15. Kim CW, Chang Y, Zhao D, Cainzos-Achirica M, Ryu S, Jung HS, et al. Sleep duration, sleep quality, and markers of subclinical arterial disease in healthy men and women. Arterioscler Thromb Vasc Biol 2015;35:2238–45.

    Google Scholar 

  16. Abe T, Aoki T, Yata S, Okada M. Sleep duration is significantly associated with carotid artery atherosclerosis incidence in a Japanese population. Atherosclerosis 2011;217:509–13.

    Google Scholar 

  17. Niijima S, Nagai M, Hoshide S, Takahashi M, Shimpo M, Kario K, et al. Long sleep duration: a nonconventional indicator of arterial stiffness in Japanese at high risk of cardiovascular disease: the J-HOP study. J Am Soc Hypertens 2016;10:429–37.

    Google Scholar 

  18. Zhou Y, Yang R, Li C, Tao M. Sleep disorder, an independent risk associated with arterial stiffness in menopause. Sci Rep 2017;7:1904.

    Google Scholar 

  19. Osonoi Y, Mita T, Osonoi T, Saito M, Tamasawa A, Nakayama S, et al. Poor sleep quality is associated with increased arterial stiffness in Japanese patients with type 2 diabetes mellitus. Bmc Endocr Disord 2015;15:29.

    Google Scholar 

  20. Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28:193–213.

    Google Scholar 

  21. Enomoto M, Endo T, Suenaga K, Miura N, Nakano Y, Kohtoh S, et al. Newly developed waist actigraphy and its sleep/wake scoring algorithm. Sleep Biol Rhythms 2009;7:17–22.

    Google Scholar 

  22. Sugawara J, Hayashi K, Yokoi T, Cortez-Cooper MY, DeVan AE, Anton MA, et al. Brachial-ankle pulse wave velocity: an index of central arterial stiffness? J Hum Hypertens 2005;19:401–6.

  23. Kumagai H, Yoshikawa T, Myoenzono K, Kosaki K, Akazawa N, Asako ZM, et al. Sexual function is an indicator of central arterial stiffness and arterial stiffness gradient in Japanese adult men. J Am Heart Assoc 2018;7:e007964.

  24. Lauderdale DS, Knutson KL, Yan LL, Liu K, Rathouz PJ. Self-reported and measured sleep duration: how similar are they? Epidemiology 2008;19:838–45.

  25. Ma CC, Burchfiel CM, Charles LE, Dorn JM, Andrew ME, Gu JK, et al. Associations of objectively measured and self-reported sleep duration with carotid artery intima media thickness among police officers. Am J Ind Med 2013;56:1341–51.

    Google Scholar 

  26. Kadoya M, Kurajoh M, Kakutani-Hatayama M, Morimoto A, Miyoshi A, Kosaka-Hamamoto K, et al. Low sleep quality is associated with progression of arterial stiffness in patients with cardiovascular risk factors: HSCAA study. Atherosclerosis 2018;270:95–101.

    Google Scholar 

  27. Tsai TC, Wu JS, Yang YC, Huang YH, Lu FH, Chang CJ. Long sleep duration associated with a higher risk of increased arterial stiffness in males. Sleep 2014;37:1315–20.

    Google Scholar 

  28. Anujuo K, Stronks K, Snijder MB, Jean-Louis G, van den Born BJ, Peters RJ, et al. Relationship between sleep duration and arterial stiffness in a multi-ethnic population: the HELIUS study. Chronobiol Int 2016;33:543–52.

    Google Scholar 

  29. Yoshioka E, Saijo Y, Kita T, Okada E, Satoh H, Kawaharada M, et al. Relation between self-reported sleep duration and arterial stiffness: a cross-sectional study of middle-aged Japanese civil servants. Sleep 2011;34:1681–6.

    Google Scholar 

  30. Rayward AT, Burton NW, Brown WJ, Holliday EG, Plotnikoff RC, Duncan MJ. Associations between changes in activity and sleep quality and duration over two years. Med Sci Sport Exer 2018;50:2425–32.

    Google Scholar 

  31. Kline CE. The bidirectional relationship between exercise and sleep: implications for exercise adherence and sleep improvement. Am J Lifestyle Med 2014;8:375–9.

    Google Scholar 

  32. Matsubara T, Miyaki A, Akazawa N, Choi Y, Ra SG, Tanahashi K, et al. Aerobic exercise training increases plasma Klotho levels and reduces arterial stiffness in postmenopausal women. Am J Physiol Heart Circ Physiol 2014;306:H348–H55.

    Google Scholar 

  33. Tanahashi K, Akazawa N, Miyaki A, Choi Y, Ra SG, Matsubara T, et al. Aerobic exercise training decreases plasma asymmetric dimethylarginine concentrations with increase in arterial compliance in postmenopausal women. Am J Hypertens 2014;27:415–21.

    Google Scholar 

  34. Yoshizawa M, Maeda S, Miyaki A, Misono M, Choi Y, Shimojo N, et al. Additive beneficial effects of lactotripeptides and aerobic exercise on arterial compliance in postmenopausal women. Am J Physiol Heart Circ Physiol 2009;297:H1899–H903.

    Google Scholar 

  35. Sugawara J, Otsuki T, Tanabe T, Hayashi K, Maeda S, Matsuda M. Physical activity duration, intensity, and arterial stiffening in postmenopausal women. Am J Hypertens 2006;19:1032–6.

    Google Scholar 

  36. Moreau KL, Donato AJ, Seals DR, DeSouza CA, Tanaka H. Regular exercise, hormone replacement therapy and the age-related decline in carotid arterial compliance in healthy women. Cardiovasc Res 2003;57:861–8.

    Google Scholar 

  37. Wilkinson IB, MacCallum H, Cockcroft JR, Webb DJ. Inhibition of basal nitric oxide synthesis increases aortic augmentation index and pulse wave velocity in vivo. Br J Clin Pharmacol 2002;53:189–92.

    Google Scholar 

  38. McEniery CM, Qasem A, Schmitt M, Avolio AP, Cockcroft JR, Wilkinson IB. Endothelin-1 regulates arterial pulse wave velocity in vivo. J Am Coll Cardiol 2003;42:1975–81.

    Google Scholar 

  39. Behl M, Bliwise D, Veledar E, Cunningham L, Vazquez J, Brigham K, et al. Vascular endothelial function and self-reported sleep. Am J Med Sci 2014;347:425–8.

    Google Scholar 

  40. Cooper DC, Ziegler MG, Milic MS, Ancoli-Israel S, Mills PJ, Loredo JS, et al. Endothelial function and sleep: associations of flow-mediated dilation with perceived sleep quality and rapid eye movement (REM) sleep. J Sleep Res 2014;23:84–93.

    Google Scholar 

  41. Trepels T, Zeiher AM, Fichtlscherer S. The endothelium and inflammation. Endothelium 2006;13:423–9.

    Google Scholar 

  42. Mattace-Raso FU, van der Cammen TJ, van der Meer IM, Schalekamp MA, Asmar R, Hofman A, et al. C-reactive protein and arterial stiffness in older adults: the Rotterdam Study. Atherosclerosis 2004;176:111–16.

    Google Scholar 

  43. Yasmin Y, McEniery C, Wallace S, Mackenzie I, Cockcroft J, Wilkinson IB. C-reactive protein is associated with arterial stiffness in apparently healthy individuals. J Hypertens 2004;22:S298.

  44. Wright Jr K P, Drake AL, Frey DJ, Fleshner M, Desouza CA, Gronfier C, et al. Influence of sleep deprivation and circadian misalignment on cortisol, inflammatory markers, and cytokine balance. Brain Behav Immun 2015;47:24–34.

    Google Scholar 

  45. Friedman EM, Hayney MS, Love GD, Urry HL, Rosenkranz MA, Davidson RJ, et al. Social relationships, sleep quality, and interleukin-6 in aging women. Proc Natl Acad Sci U S A 2005;102:18757–62.

    Google Scholar 

  46. Rangel-Zuñiga OA, Cruz-Teno C, Haro C, Quintana-Navarro GM, Camara-Martos F, Perez-Martinez P, et al. Differential menopause- versus aging-induced changes in oxidative stress and circadian rhythm gene markers. Mech Ageing Dev 2017;164:41–8.

    Google Scholar 

  47. Hildreth KL, Kohrt WM, Moreau KL. Oxidative stress contributes to large elastic arterial stiffening across the stages of the menopausal transition. Menopause 2014;21:624–32.

    Google Scholar 

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Correspondence to Seiji Maeda.

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Peer review under responsibility of the Association for Research into Arterial Structure and Physiology

Data availability statement: The authors confirm that the data supporting the findings of this study are available within the article.

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Choi, Y., Akazawa, N., Zempo-Miyaki, A. et al. Sleep Quality is associated with Central Arterial Stiffness in Postmenopausal Women: A Cross-sectional Pilot Study. Artery Res 27, 14–19 (2021). https://doi.org/10.2991/artres.k.201004.001

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