Too Much and Too Little Sleep Linked To Increased Coronary Artery Calciification

Chan-Won Kim, M.D. Clinical Associate Professor Center for Cohort Studies Kangbuk Samsun Hospital Sungkyunkwan University School of Medicine Seoul, South Interview with:
Chan-Won Kim, M.D
Clinical Associate Professor
Center for Cohort Studies
Kangbuk Samsun Hospital
Sungkyunkwan University School of Medicine
Seoul, South Korea

Medical Research: What is the background for this study?

Dr. Chan-Won Kim: In modern society, inadequate sleep either in quantity or in quality is a common problem and widely recognized as a potential determinant of adverse health outcomes including cardiovascular health. Very long or very short duration of sleep are associated with an increased risk for clinical cardiovascular events such as coronary heart disease and strokes. In these previous studies, however, it was possible that extreme sleep duration or poor sleep quality was a consequence of previous co-morbidities such as depression and obesity, and it was still unclear if these co-morbidities were really responsible for the effects of sleep disturbances. Therefore, we evaluated the association of sleep duration and quality with early markers of subclinical arterial disease in asymptomatic apparently healthy men and women.

Medical Research: What are the main findings?

Dr. Chan-Won Kim:  In our study, we found that sleep duration had a U-shaped association with two early markers of vascular disease. Both short and long sleep duration were associated with a greater amount of calcification in the coronary arteries, a very good measure of subclinical atherosclerosis that predicts the risk of a heart attack. We also found a similar pattern of association with arterial stiffness, a marker of vascular aging. For both markers, we found the lowers risk in study participants who reported 7 hours of sleep. In addition, poor subjective sleep quality was also associated with these markers of vascular disease. Few studies had explored these associations before, and they were inconsistent partly because of small sample sizes. Our research also indicates that these associations were present irrespective of traditional risk factors such as hypertension, hypercholesterolemia, or diabetes.

Medical Research: What should clinicians and patients take away from your report?

Dr. Chan-Won Kim: Many people, up to one third or one fourth of the population, suffer from inadequate sleep – either insufficient duration of sleep or poor sleep quality. Inadequate sleep can result in many health problems, including psychological problems, but our study indicates that it can also affect cardiovascular disease even in healthy adults and should be considered as a modifiable risk factor for cardiovascular disease. For clinicians, it can be helpful to evaluate sleep duration and quality when they assess the health status of their patients.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Chan-Won Kim: We encourage more research on the mechanism underlying the associations of extreme sleep duration and poor quality with cardiovascular disease to better understand the adverse effects of inadequate sleep on cardiovascular health. Future research is also needed to address the effect of improving sleep duration and sleep quality in preventing cardiovascular disease.


Chan-Won Kim, Yoosoo Chang, Di Zhao, Miguel Cainzos-Achirica, Seungho Ryu, Hyun-Suk Jung, Kyung Eun Yun, Yuni Choi, Jiin Ahn, Yiyi Zhang, Sanjay Rampal, Youngji Baek, Joao A. Lima, Hocheol Shin, Eliseo Guallar, Juhee Cho, Eunju Sung. Sleep Duration, Sleep Quality, and Markers of Subclinical Arterial Disease in Healthy Men and Women.Arteriosclerosis, Thrombosis, and Vascular Biology, 2015; ATVBAHA.115.306110 DOI: 10.1161/ATVBAHA.115.306110

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Last Updated on September 12, 2015 by Marie Benz MD FAAD