Traditional and nontraditional cardiovascular risk factors in comorbid insomnia and sleep apnea

Area of Science:

• Cardiology
• Sleep Medicine
• Public Health

Background:

• Insomnia and sleep apnea are common, independently linked to cardiovascular disease (CVD).
• Limited data exists on CVD risk in individuals with both insomnia and sleep apnea.
• This study investigates CVD risk factors in comorbid insomnia and sleep apnea.

Purpose of the Study:

• To examine traditional CVD risk factors and a physiologic biomarker in individuals with comorbid insomnia and sleep apnea.
• To compare CVD risk profiles between groups with insomnia alone, sleep apnea alone, comorbid conditions, and neither.
• To understand the specific contribution of comorbid insomnia to CVD risk.

Main Methods:

• Community-based participatory research design.
• Sample of 795 participants without pre-existing CVD from the Heart SCORE study.
• Assessment of insomnia symptoms, sleep apnea risk, traditional CVD risk factors (obesity, smoking, sedentary lifestyle, hypertension, dyslipidemia, diabetes), and brachial artery diameter.

Main Results:

• 17.4% had insomnia alone, 22.5% high sleep apnea risk alone, 11.9% comorbid insomnia and sleep apnea, 48.2% neither.
• Sleep apnea (alone or comorbid) groups showed higher frequencies of obesity, sedentary lifestyle, hypertension, and multiple CVD risk factors.
• Groups with sleep apnea had significantly larger brachial artery diameters compared to the insomnia alone and neither groups.
• No significant differences in CVD risk factors or brachial artery diameter were found between high sleep apnea risk alone and comorbid groups.

Conclusions:

• Sleep apnea is a significant contributor to cardiovascular risk.
• Co-occurring insomnia does not appear to exacerbate cardiovascular risk beyond that posed by sleep apnea alone.
• Findings highlight sleep apnea as a key target for cardiovascular risk reduction.