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Sleep Duration and Snoring in Relation to Biomarkers of Cardiovascular Disease Risk Among Women With Type 2 Diabetes

¹ Department of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
² Department of Nutrition and Epidemiology, Harvard School of Public Health, Boston, Massachusetts
³ Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
⁴ Pulmonary and Critical Care Medicine, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio

Address correspondence and reprint requests to Dr. Christos Mantzoros, Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Center, 330 Brookline Ave., ST816, Boston, MA 02115. E-mail: cmantzor{at}bidmc.harvard.edu

OBJECTIVE—Sleep habits have been associated with risk of cardiovascular disease (CVD) and metabolic disturbances, but the mechanisms underlying these associations have yet to be fully elucidated. We aim to determine whether sleep duration and/or snoring are associated with biomarkers of CVD in women with type 2 diabetes.

RESEARCH DESIGN AND METHODS—We studied 935 women aged 43–69 years enrolled in the Nurses’ Health Study cohort with type 2 diabetes who had no history of documented coronary heart disease or stroke in 1990. Information on sleep duration and snoring frequency was collected in 1986 from mailed questionnaires, and biomarkers of CVD were measured from blood samples taken in 1989–1990.

RESULTS—Longer sleep duration was associated with increased levels of C-reactive protein after adjusting for age, BMI, lifestyle factors, family history of diabetes, glycemic control, and medication use (P = 0.05). HDL was decreased with short and long sleep duration among normotensive (P = 0.02) but not hypertensive women. More frequent snoring was directly associated with triglycerides (P = 0.02) and inversely associated with HDL cholesterol (0.03) and adiponectin (P = 0.03) in multivariate-adjusted analyses.

CONCLUSIONS—The associations of sleep duration and snoring with lipid profile, hormone measures, and/or inflammatory markers may partially explain the previously reported relationship between sleep habits and cardiovascular and metabolic disorders.

Abbreviations: CRP, C-reactive peptide • CVD, cardiovascular disease • NHS, Nurses’ Health Study • OSA, obstructive sleep apnea • sICAM-1, soluble intercellular adhesion molecule 1 • TNF, tumor necrosis factor • WHR, waist-to-hip ratio

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