Correlation of Sleep Duration and Sleep Quality With Coronary Atherosclerotic Plaque Vulnerability: An Optical...

Previous studies have shown a strong link between sleep and cardiovascular disease. However, the association of sleep duration and quality with coronary atherosclerotic plaque vulnerability remains unclear. This study aimed to investigate the correlation between sleep duration, sleep quality, and coronary plaque vulnerability using optical coherence tomography (OCT).

A total of 260 patients with stable angina who completed an OCT examination were included. Patients were divided into a thin-cap fibroatheroma (TCFA) group and a non-TCFA group according to the presence of TCFA on OCT. The sleep duration of the patients was recorded by questionnaire, and the sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI).

The TCFA group had significantly shorter sleep duration and higher PSQI values (p < 0.05). A multivariable logistic regression analysis revealed that sleep duration and PSQI were independent predictors of TCFA (p < 0.05). A receiver operating characteristic (ROC) study demonstrated that the area under the curve values for sleep duration and PSQI were 0.698 and 0.721, respectively, in predicting the presence of TCFA. Patients with a sleep duration ≤5.5 hours or a PSQI value >9 had a thinner fibrous cap thickness, a larger maximal lipid pool arc, and a higher incidence of TCFA and macrophage deposition (p < 0.05). Sleep duration was positively correlated with the thinnest fibrous cap thickness (r = 0.451; p < 0.001), and negatively correlated with the radian of the maximum lipid pool (r = -0.470; p < 0.001). The PSQI was negatively correlated with the thinnest fibrous cap thickness (r = -0.477; p < 0.001), and positively correlated with the radian of maximum lipid pool (r = 0.340; p < 0.001).

Both sleep duration and sleep quality were significantly associated with coronary plaque vulnerability. Patients with either insufficient sleep duration or poor sleep quality exhibited significantly greater plaque vulnerability.