Endothelial function and sleep: associations of flow‐mediated dilation with perceived sleep quality and rapid eye movement (REM) sleep |
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Authors: | Denise C Cooper Michael G Ziegler Milos S Milic Sonia Ancoli‐Israel Paul J Mills José S Loredo Roland Von Känel Joel E Dimsdale |
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Institution: | 1. Health Services Research and Development, VA Puget Sound Health Care System, , Seattle, WA, USA;2. Department of Medicine, University of California‐San Diego, , La Jolla, CA, USA;3. Department of Psychiatry, University of California‐San Diego, , La Jolla, CA, USA;4. Division of Psychosomatic Medicine, Department of General Internal Medicine, Inselspital, Bern University Hospital and University of Bern, , Bern, Switzerland |
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Abstract: | 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 Pittsburgh Sleep Quality Index, 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. Pittsburgh Sleep Quality Index scores) and objective (i.e. polysomnography‐derived) indicators of sleep quality. After FMD showed bivariate correlations with Pittsburgh Sleep Quality Index 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 (Ps < 0.05). Specifically, as FMD decreased, scores on the Pittsburgh Sleep Quality Index increased (indicating decreased subjective sleep quality) and percentage REM sleep decreased, while REM sleep latency increased (Ps < 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. |
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Keywords: | endothelial function polysomnography sleep subjective sleep quality vasodilation |
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