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Association of Rest-Activity Rhythm and Sleep Regularity With Cardiometabolic Disease in the CARDIA Study
Swaty Chapagai1, Pamela J Schreiner2, S Justin Thomas3
1Center for Circadian and Sleep Medicine, Department of Neurology Northwestern University Feinberg School of Medicine Chicago IL USA.
Insights
Disrupted circadian rhythms, indicated by irregular sleep patterns, are linked to unfavorable body mass index and glucose levels. These associations showed minimal differences between racial groups, except for relative amplitude impacting body mass index more in White participants.
Area of Science:
- Chronobiology
- Cardiovascular Health
- Race and Health Disparities
Background:
- Disrupted circadian rhythms are increasingly recognized as a contributing factor to cardiometabolic diseases.
- Understanding the relationship between rest-activity patterns and cardiometabolic health across different racial groups is crucial for targeted interventions.
Purpose of the Study:
- To investigate the association between rest-activity rhythms and cardiometabolic disease markers.
- To examine potential effect modification by race in these associations.
Main Methods:
- Cross-sectional analysis of 861 participants from the CARDIA sleep ancillary study using wrist actigraphy for 7 days.
- Calculation of Sleep Regularity Index and various rest-activity rhythm measures (interdaily stability, intradaily variability, relative amplitude, etc.).
- Assessment of cardiometabolic markers including BMI, waist circumference, blood pressure, glucose, insulin resistance, and diabetes, with analysis of effect modification by race.
Main Results:
- Weaker rest-activity rhythms and irregular sleep were associated with higher body mass index and waist circumference, particularly the relative amplitude measure.
- Effect modification by race was observed for relative amplitude's association with body mass index, showing stronger links in White participants.
- Associations with glycemic markers were generally consistent across racial groups, while links to blood pressure were less consistent.
Conclusions:
- Less robust rest-activity rhythms and irregular sleep are associated with poorer anthropometric and glycemic health indicators.
- The impact of disrupted circadian rhythms on cardiometabolic markers shows some racial differences, though generally minimal.
- Rest-activity rhythm disruption appears weakly associated with blood pressure, with few observed racial disparities.
Background:
Disrupted circadian rhythms are associated with cardiometabolic disease. We examined associations between rest-activity rhythms and cardiometabolic disease by race.
Methods:
In cross-sectional analysis of the CARDIA (Coronary Artery Risk Development in Young Adults) sleep ancillary study (2020-2023), 861 participants wore wrist actigraphy for 7 days. Sleep Regularity Index and rest-activity rhythm measures were calculated: interdaily stability, intradaily variability, relative amplitude, and most active 10-hour and least active 5-hour period start times. Cardiometabolic disease markers included body mass index, waist circumference, blood pressure, hypertension, fasting glucose, estimated insulin resistance, and diabetes. Linear regression models with interaction terms evaluated effect modification by race.
Results:
Among 354 Black and 507 White participants, the most consistent associations were between anthropometric markers and rest-activity rhythms. Except for most active 10-hour start, remaining indices and Sleep Regularity Index were associated with body mass index with β coefficients ranging from -1.74 to 0.86, consistent with our hypothesis that weaker rest-activity rhythms relate to larger body mass index. There was some effect modification by race (P<0.01), with relative amplitude showing stronger associations with body mass index in White (β=-2.63 [95% CI, -3.34 to -1.93]) versus Black (β=-1.24 [95% CI, -1.97 to -0.50]) participants. Patterns, including effect modification for relative amplitude, were similar for waist circumference. Disrupted circadian indices were associated with glycemic markers, with findings generally consistent by race. Associations between rest-activity rhythms and blood pressure were less consistent overall and by race.
Conclusions:
Less robust rest-activity rhythms and irregular sleep were associated with less favorable anthropometric and glycemic markers but weakly associated with blood pressure, with few racial differences.
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