Poor Sleep May Increase Odds for Atherosclerosis in Peri-, Postmenopausal Women

Menopausal Hormone Therapy Does Not Affect Atherosclerosis
Menopausal Hormone Therapy Does Not Affect Atherosclerosis
Both peri- and postmenopausal women were assessed to find a relationship between sleep time, sleep quality, and carotid atherosclerosis.

Objective sleep time and subjective sleep quality can be linked to an increased risk of carotid atherosclerosis in midlife women, according to research presented at the North American Menopause Society (NAMS) 2016 Annual Meeting.

Rebecca C. Thurston, PhD, professor in the department of psychiatry at the University of Pittsburgh, and colleagues conducted a study to determine if shorter objectively assessed sleep time or poorer subjective sleep quality could be associated with elevated carotid atherosclerosis in women aged 40 to 60 years.

Study participants (n=256) were nonsmoking peri- and postmenopausal women who had each had their  uterus and at least 1 ovary removed. No women had a history of clinical cardiovascular disease (CVD); worked a night shift; or took medication to assist with sleep (eg, melatonin, sedatives or hypnotics, or antihistamines), hot flashes (eg, estrogen, progesterone, selective serotonin or serotonin-norepinephrone reuptake inhibitors, gabapentin, or clonidine), or medications that impact the CV system (eg, beta blockers, calcium channel blockers, ACE inhibitors, or insulin).

Participants completed 3 days of wrist actigraphy, 24-hour hot flash monitoring, a blood draw, a carotid ultrasound, and questionnaires including the Pittsburgh Sleep Quality Index (PSQI) and questionnaires focused on depressive and apnea symptoms. Covariates of interest included age, race, BMI, systolic and diastolic blood pressure, LDL and HDL cholesterol, and insulin resistance, among others.

Dr Thurston and colleagues found that shorter objective sleep time was associated with a 58% higher odds of developing carotid plaque (odds ratio [OR]: 1.58; 95% CI, 1.11-2.27; P =.01; plaque score=1, OR: 0.95, 95% CI, 0.68-1.32, P =.75, relative to no plaque). Intima media thickness (IMT) as determined by the carotid ultrasound was highest among women who slept 5 to 6 hours (IMT=0.70 mm); IMT of women who slept 6 to 7 hours was 0.66 mm. Poorer subjective sleep quality was also associated with higher IMT, higher plaque (OR: 1.23, 95% CI, 1.09-1.40, P =.001; score=1, OR: 1.06, 95% CI, 0.93-1.21, P =.37, relative to no plaque).

“Poor sleep during menopause transition may have implications for women’s cardiovascular health at midlife,” Dr Thurston and colleagues concluded.

“This study highlights the need for health care providers to have meaningful conversations with their menopausal patients about their sleep patterns in order to fully assess their risks for strokes and heart disease,” JoAnn Pinkerton, MD, executive director of NAMS, said in a press release.

Disclosures: This study was supported by National Institutes of Health/National Heart, Lung, and Blood Institute Grands R01HL105647 and K24HL123565. Dr Thurston reports no conflicts of interest. Dr Pinkerton reports relationships with Henry Stewart, Pfizer, and TherapeuticsMD.

For more coverage of NAMS 2016, click here.

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  1. Thurston RC, Chang Y, von Känel R, et al. Abstract S-16. Sleep characteristics and carotid atherosclerosis among midlife women.  Presented at: NAMS 2016 Annual Meeting; October 5-8, 2016; Orlando, FL.
  2. New Study Proves Link Between Disrupted Sleep and Heart Disease in Menopausal Women. Cleveland, OH: NAMS Press Room; September 19, 2016. http://www.menopause.org/docs/default-source/2016-docs/depression-increases-risk-of-heart-disease-9-19-16-km.pdf. Accessed October 4, 2016.