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Sleep. 2021 Nov 12;44(11). doi: 10.1093/sleep/zsab164.

Racial disparities in sleep-related cardiac function in young, healthy adults: implications for cardiovascular-related health.

Sleep

Janelle E Letzen, Mercedes L Robinson, Jared M Saletin, Rosanne B Sheinberg, Michael T Smith, Claudia M Campbell

Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA.
  2. Department of Neurology, School of Medicine, University of California, San Francisco, San Francisco, CA, USA.
  3. Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
  4. Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.

PMID: 34214173 PMCID: PMC8598177 DOI: 10.1093/sleep/zsab164

Abstract

STUDY OBJECTIVES: Considerable evidence shows that individuals from marginalized racial/ethnic groups in the United States experience greater rates of sleep disturbance and cardiovascular complications. Because sleep is a modifiable factor that is critically involved in cardiovascular health, improved understanding of the association between sleep and cardiovascular health during early adulthood can prevent cardiovascular disparities. This study examined racial/ethnic differences in cardiovascular function during sleep using heart rate and heart-rate-variability analyses.

METHODS: Participants in this laboratory-based sleep study included healthy, "good sleepers" who were in early adulthood and resided in the United States at the time of participation (14 non-Hispanic Black [NHB; age = 30.9 (6.6), 57% female], 12 Asian [Asian, age = 26.0 (5.2), 42% female], and 24 non-Hispanic white [NHW; age = 24.6 (5.8), 79% female]).

RESULTS: After adjusting for demographic factors and an apnea-hypopnea index, we found significantly higher heart rate within NREM Stage 2 (N2) (b = -22.6, p = .04) and REM sleep (b = -25.8, p =.048) and lower heart rate variability during N2 sleep (b = -22.6, p = .04) among NHB individuals compared with NHW individuals. Furthermore, NHB and Asian participants demonstrated significantly lower percent of time in slow wave sleep (SWS) compared with NHW participants (NHB: b = -22.6, p =.04; Asian: b = -22.6, p = .04). Individuals' percent of time in SWS significantly mediated differences in heart rate during N2 (indirect = 0.94, 95% CI [0.03, 2.68]) and REM sleep (indirect = 1.02, 95% CI [0.04, 3.04]).

CONCLUSIONS: Our results showed disparities in sleep-related cardiovascular function in early adulthood that are mediated by SWS. These data suggest targeting sleep health in early adulthood might help reduce cardiovascular disease burden on individuals from marginalized groups.

© Sleep Research Society 2021. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please email: [email protected].

Keywords: SWS; cardiovascular health; heart rate variability; sleep disparities

References

  1. Sleep. 2014 Jan 01;37(1):147-56 - PubMed
  2. Sleep. 2007 Apr;30(4):494-505 - PubMed
  3. Curr Opin Cardiol. 2016 Sep;31(5):551-65 - PubMed
  4. Circulation. 2015 Jan 27;131(4):e29-322 - PubMed
  5. Arch Intern Med. 2008 May 12;168(9):996-1002 - PubMed
  6. J Hypertens. 2008 Aug;26(8):1571-6 - PubMed
  7. Am J Crim Justice. 2020 Jul 7;:1-21 - PubMed
  8. Psychiatry Clin Neurosci. 2001 Jun;55(3):305-10 - PubMed
  9. Neurosci Biobehav Rev. 2018 Jul;90:84-103 - PubMed
  10. Health Psychol. 2006 Sep;25(5):635-42 - PubMed
  11. Behav Res Methods. 2008 Aug;40(3):879-91 - PubMed
  12. Behav Res Ther. 2017 Nov;98:39-57 - PubMed
  13. J Clin Med. 2019 Nov 12;8(11): - PubMed
  14. Sleep. 2015 Jun 01;38(6):877-88 - PubMed
  15. Sleep Med. 2016 Feb;18:50-5 - PubMed
  16. BMJ Open. 2019 Jul 17;9(7):e030559 - PubMed
  17. Psychiatry Res. 1989 May;28(2):193-213 - PubMed
  18. Am J Hum Biol. 2002 May-Jun;14(3):321-6 - PubMed
  19. J Korean Med Sci. 2008 Apr;23(2):226-31 - PubMed
  20. Public Health Rep. 2003 Jul-Aug;118(4):358-65 - PubMed
  21. Sleep. 2019 Feb 1;42(2): - PubMed
  22. Nat Sci Sleep. 2019 Jul 23;11:79-95 - PubMed
  23. Neurosci Biobehav Rev. 2016 May;64:288-310 - PubMed
  24. Am J Hypertens. 1996 Dec;9(12 Pt 1):1157-64 - PubMed
  25. CMAJ. 2016 Feb 16;188(3):E53-E63 - PubMed
  26. Circulation. 1996 Mar 1;93(5):1043-65 - PubMed
  27. Front Psychol. 2017 Nov 15;8:1984 - PubMed
  28. Stroke. 2011 Nov;42(11):3196-201 - PubMed
  29. Sleep Med. 2016 Feb;18:88-95 - PubMed
  30. Sleep. 2018 Jun 1;41(6): - PubMed
  31. Hypertension. 2011 Oct;58(4):596-603 - PubMed
  32. Curr Hypertens Rep. 2012 Oct;14(5):442-8 - PubMed
  33. J Cardiol. 2010 Jul;56(1):27-34 - PubMed
  34. Sleep. 2019 May 1;42(5): - PubMed
  35. Psychosom Med. 2008 May;70(4):410-6 - PubMed
  36. Pain. 1987 Aug;30(2):191-197 - PubMed
  37. Psychosom Med. 2013 Oct;75(8):783-90 - PubMed
  38. Heart Rhythm. 2009 Nov;6(11 Suppl):S68-75 - PubMed
  39. J Health Care Poor Underserved. 2010 Aug;21(3):879-97 - PubMed
  40. Sleep Med. 2011 Mar;12(3):209-14 - PubMed
  41. Eur Heart J. 2013 Jun;34(23):1732-9 - PubMed
  42. Am J Physiol Regul Integr Comp Physiol. 2010 Jan;298(1):R191-7 - PubMed
  43. Front Public Health. 2017 Sep 28;5:258 - PubMed
  44. Curr Hypertens Rep. 2019 May 22;21(7):51 - PubMed
  45. Sleep Sci. 2019 Oct-Dec;12(4):257-264 - PubMed
  46. Biol Psychol. 2012 Jan;89(1):34-8 - PubMed
  47. Epidemiology. 2008 Nov;19(6):838-45 - PubMed
  48. Europace. 2013 May;15(5):742-9 - PubMed
  49. Cardiol Clin. 1992 Aug;10(3):487-98 - PubMed
  50. Front Physiol. 2017 Aug 24;8:582 - PubMed
  51. Sleep Med Rev. 2017 Jun;33:70-78 - PubMed
  52. J Clin Sleep Med. 2009 Apr 15;5(2 Suppl):S6-15 - PubMed
  53. Behav Res Methods. 2007 May;39(2):175-91 - PubMed
  54. Am J Cardiol. 1990 Dec 15;66(20):1522-4 - PubMed
  55. J Clin Sleep Med. 2013 Apr 15;9(4):303-9 - PubMed
  56. Sleep. 1991 Dec;14(6):540-5 - PubMed
  57. J Natl Med Assoc. 2012 Jan-Feb;104(1-2):89-95 - PubMed
  58. Sleep. 2018 Jan 1;41(1): - PubMed
  59. J Orofac Pain. 2011 Summer;25(3):232-9 - PubMed
  60. Annu Rev Public Health. 2015 Mar 18;36:417-40 - PubMed
  61. Asian J Psychiatr. 2009 Mar 1;2(1):17-24 - PubMed
  62. Sleep. 2013 Dec 01;36(12):1919-28 - PubMed
  63. N Engl J Med. 2020 Nov 26;383(22):e121 - PubMed

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