Dusan Petrovic1, José Haba-Rubio2, Carlos de Mestral Vargas1, Michelle Kelly-Irving3,4, Paolo Vineis5, Mika Kivimäki6, Solja Nyberg7, Martina Gandini8, Murielle Bochud1, Peter Vollenweider1, Angelo d'Errico8, Henrique Barros9, Silvia Fraga9, Marcel Goldberg10,11, Marie Zins10,11, Andrew Steptoe6, Cyrille Delpierre3,4, Raphael Heinzer2, Cristian Carmeli1, Marc Chadeau-Hyam5, Silvia Stringhini1,12. 1. Centre universitaire de médecine Générale et santé publique (UNISANTÉ), Institute of Social and Preventive Medicine (IUMSP), Route de la Corniche 10, 1010 Lausanne, Switzerland. 2. Center for Investigation and Research in Sleep, Lausanne University Hospital, Lausanne, Switzerland. 3. INSERM, UMR 1027, Toulouse, France. 4. Université Toulouse III Paul-Sabatier, UMR1027, Toulouse, France. 5. Department of Epidemiology and Biostatistics, Centre for Environment and Health, School of Public Health, Imperial College London, London, UK. 6. Department of Epidemiology and Public Health, University College London, London, UK. 7. Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland. 8. Epidemiology Unit, ASL TO3 Piedmont Region, Grugliasco, Italy. 9. EPIUnit-Institute of Public Health, University of Porto, Porto, Portugal. 10. Population-Based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif, France. 11. Paris Descartes University, Paris, France. 12. Unit of Population Epidemiology, Primary Care Division, Geneva University Hospital, Geneva, Switzerland.
Abstract
AIMS: Sleep disturbances exhibit a strong social patterning, and inadequate sleep has been associated with adverse health outcomes, including cardiovascular disorders (CVD). However, the contribution of sleep to socioeconomic inequalities in CVD is unclear. This study pools data from eight European cohorts to investigate the role of sleep duration in the association between life-course socioeconomic status (SES) and CVD. METHODS AND RESULTS: We used cross-sectional data from eight European cohorts, totalling 111 205 participants. Life-course SES was assessed using father's and adult occupational position. Self-reported sleep duration was categorized into recommended (6-8.5 h/night), long (>8.5 h/night), and short (<6 h/night). We examined two cardiovascular outcomes: coronary heart disease (CHD) and stroke. Main analyses were conducted using pooled data and examined the association between life-course SES and CVD, and the contribution of sleep duration to this gradient using counterfactual mediation. Low father's occupational position was associated with an increased risk of CHD (men: OR = 1.19, 95% CI [1.04; 1.37]; women: OR = 1.25, 95% CI [1.02; 1.54]), with marginal decrease of the gradient after accounting for adult occupational position (men: OR = 1.17, 95% CI [1.02; 1.35]; women: OR = 1.22, 95% CI [0.99; 1.52]), and no mediating effect by short sleep duration. Low adult occupational position was associated with an increased risk of CHD in both men and women (men: OR = 1.48, 95% CI [1.14; 1.92]; women: OR = 1.53, 95% CI [1.04; 2.21]). Short sleep duration meaningfully contributed to the association between adult occupational position and CHD in men, with 13.4% mediation. Stroke did not exhibit a social patterning with any of the variables examined. CONCLUSION: This study suggests that inadequate sleep accounts to a meaningful proportion of the association between adult occupational position and CHD, at least in men. With sleep increasingly being considered an important cardiovascular risk factor in its own terms, our study additionally points to its potential role in social inequalities in cardiovascular disease. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Sleep disturbances exhibit a strong social patterning, and inadequate sleep has been associated with adverse health outcomes, including cardiovascular disorders (CVD). However, the contribution of sleep to socioeconomic inequalities in CVD is unclear. This study pools data from eight European cohorts to investigate the role of sleep duration in the association between life-course socioeconomic status (SES) and CVD. METHODS AND RESULTS: We used cross-sectional data from eight European cohorts, totalling 111 205 participants. Life-course SES was assessed using father's and adult occupational position. Self-reported sleep duration was categorized into recommended (6-8.5 h/night), long (>8.5 h/night), and short (<6 h/night). We examined two cardiovascular outcomes: coronary heart disease (CHD) and stroke. Main analyses were conducted using pooled data and examined the association between life-course SES and CVD, and the contribution of sleep duration to this gradient using counterfactual mediation. Low father's occupational position was associated with an increased risk of CHD (men: OR = 1.19, 95% CI [1.04; 1.37]; women: OR = 1.25, 95% CI [1.02; 1.54]), with marginal decrease of the gradient after accounting for adult occupational position (men: OR = 1.17, 95% CI [1.02; 1.35]; women: OR = 1.22, 95% CI [0.99; 1.52]), and no mediating effect by short sleep duration. Low adult occupational position was associated with an increased risk of CHD in both men and women (men: OR = 1.48, 95% CI [1.14; 1.92]; women: OR = 1.53, 95% CI [1.04; 2.21]). Short sleep duration meaningfully contributed to the association between adult occupational position and CHD in men, with 13.4% mediation. Stroke did not exhibit a social patterning with any of the variables examined. CONCLUSION: This study suggests that inadequate sleep accounts to a meaningful proportion of the association between adult occupational position and CHD, at least in men. With sleep increasingly being considered an important cardiovascular risk factor in its own terms, our study additionally points to its potential role in social inequalities in cardiovascular disease. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Sanjay R Patel; Najib T Ayas; Mark R Malhotra; David P White; Eva S Schernhammer; Frank E Speizer; Meir J Stampfer; Frank B Hu Journal: Sleep Date: 2004-05-01 Impact factor: 5.849
Authors: Kaitlyn M Eck; Elena Santiago; Jennifer Martin-Biggers; Carol Byrd-Bredbenner Journal: Int J Environ Res Public Health Date: 2020-07-23 Impact factor: 3.390