Gender differences of cardiovascular diseases risk in the population with sleep disorders: WHO’s program MONICA-psychosocial

Gafarov V.V.; Gromova E.A.; Panov D.O.; Gagulin I.V.; Gafarova A.V.

doi:https://doi.org/10.17116/jnevro202112105198

Gafarov V.V.

Research Institute of Therapy and Preventive Medicine — branch of the Institute of Cytology and Genetics Siberian Branch of the Russian Academy of Sciences;
Collaborative Laboratory of Epidemiology of Cardiovascular Diseases

ORCID: 0000-0001-5701-7856

Gromova E.A.

ORCID: 0000-0001-8313-3893

Panov D.O.

Research Institute of Therapy and Preventive Medicine of the Branch of the Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences;
Collaborative laboratory of Cardiovascular Diseases Epidemiology

Gagulin I.V.

ORCID: 0000-0001-5255-5647

Gafarova A.V.

ORCID: 0000-0001-5380-9434

Gender differences of cardiovascular diseases risk in the population with sleep disorders: WHO’s program MONICA-psychosocial

Authors:

Gafarov V.V., Gromova E.A., Panov D.O., Gagulin I.V., Gafarova A.V.

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Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2021;121(5): 98‑104

DOI: 10.17116/jnevro202112105198

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To cite this article:

Gafarov VV, Gromova EA, Panov DO, Gagulin IV, Gafarova AV. Gender differences of cardiovascular diseases risk in the population with sleep disorders: WHO’s program MONICA-psychosocial. S.S. Korsakov Journal of Neurology and Psychiatry. 2021;121(5):98‑104. (In Russ.)
https://doi.org/10.17116/jnevro202112105198

Подписка 2026 Журнал неврологии и психиатрии им. С.С. Корсакова (S.S. Korsakov Journal of Neurology and Psychiatry)

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OBJECTIVE

To determine the gender differences in the effect of sleep disorders (SD) on the risk of myocardial infarction (MI) and stroke in an open population, aged 25-64 years, of Russia/Siberia over 16 years of follow-up.

MATERIAL AND METHODS

Within the framework of the III screening of WHO’s MONICA-psychosocial program, a random representative sample of the Novosibirsk population, which comprised both sexes (657 men, 689 women), aged 25-64 years, was examined in 1994. The screening included socio-demographic data, the assessment of SD according to the Jenkins scale. The analysis included people without MI, stroke. In 16 years, new-onset cases of MI and stroke were identified in women (15 and 35 cases, respectively) and in men (30 and 22 cases, respectively).

RESULTS

In the open population among the population of 25-64 years, 48.6% of men and 65.9% of women had SD (c²=24.427, df=1, p=0.0001). In people with SD, a single-factor Cox regression analysis revealed that the risk of stroke was higher in men than in women within a 16-year period. Multivariate Cox regression analysis revealed that in people with SD, the risk of stroke in men and women is approximately the same. Widowed men with SD had an increased risk of stroke. The risk of stroke was higher in men with incomplete secondary / primary education than in women. There was an increased risk of stroke in women with secondary education and those having sleep problems. Cox single-factor regression analysis showed an increased risk of MI (by 2.4 times) in men with SD for a 16-year period. SD did not influence the risk of MI in women. The risk of MI was 3 times higher in never-married men, 4.3 times higher in divorced men and 7.5 times higher in widowed men.

CONCLUSION

SD are a risk factor for stroke in men and women, and a risk factor of MI in men. A negative social gradient increases the risk of cardiovascular diseases in people with SD.

Keywords:

sleep

gender differences

sleep disturbance

myocardial infarction

stroke

relative risk

Authors:

Gafarov V.V.

ORCID: 0000-0001-5701-7856

Gromova E.A.

ORCID: 0000-0001-8313-3893

Panov D.O.

Gagulin I.V.

ORCID: 0000-0001-5255-5647

Gafarova A.V.

ORCID: 0000-0001-5380-9434

Received:

31.01.2020

Accepted:

05.05.2020

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References:

Ohayon MM. Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev. 2002;6(2):97-111. https://doi.org/10.1053/smrv.2002.0186
Roth T. Insomnia: definition, prevalence, etiology, and consequences. J Clin Sleep Med. 2007;3(5 suppl):7-10.
Kato M, Phillips BG, Sigurdsson G, et al. Effects of sleep deprivation on neural circulatory control. Hypertension. 2000;35(5):1173-1175. https://doi.org/10.1161/01.hyp.35.5.1173
Lusardi P, Mugellini A, Preti P, et al. Effects of a restricted sleep regimen on ambulatory blood pressure monitoring in normotensive subjects. Am J Hypertens. 1996;9(5):503-505. https://doi.org/10.1016/0895-7061(95)00389-4
Lusardi P, Zoppi A, Preti P, et al. Effects of insufficient sleep on blood pressure in hypertensive patients: a 24-h study. Am J Hypertens. 1999;12(1 Pt 1):63-68. https://doi.org/10.1016/s0895-7061(98)00200-3
Meier-Ewert HK, Ridker PM, Rifai N, et al. Effect of sleep loss on C-reactive protein, an inflammatory marker of cardiovascular risk. J Am Coll Cardiol. 2004;43(4):678-683. https://doi.org/10.1016/j.accreview.2004.03.057
Miller MA, Kandala NB, Kumari M, et al. Relationships between sleep duration and von Willebrand factor, factor VII, and fibrinogen: Whitehall II study. Arterioscler Thromb Vasc Biol. 2010;30(10):2032-2038. https://doi.org/10.1161/atvbaha.110.206987
Shearer WT, Reuben JM, Mullington JM, et al. Soluble TNF-alpha receptor 1 and IL-6 plasma levels in humans subjected to the sleep deprivation model of spaceflight. J Allergy Clin Immunol. 2001;107(1):165-170. https://doi.org/10.1067/mai.2001.112270
King CR, Knutson KL, Rathouz PJ, et al. Short sleep duration and incident coronary artery calcification. JAMA. 2008;300(24):2859-2866. https://doi.org/10.1001/jama.2008.867
Lim AS, Myers AJ, Yu L, et al. Sex difference in daily rhythms of clock gene expression in the aged human cerebral cortex. J Biol Rhythms. 2013;28(2):117-129. https://doi.org/10.1177/0748730413478552
WHO MONICA; Project prepared by Kuulasmaa K, Pajak A, Ruokokoski E, et al. Baseline population survey data book. Helsinki; 1990.
World Health Organization. Proposal for the Multinational Monitoring of Trends in cardiovascular disease. Geneva; 1985.
World Health Organization. MONICA Psychosocial Optional Study. Suggested Measurement Instruments. Copenhagen; 1988.
The World Health Organization MONICA Project (monitoring trends and determinants in cardiovascular disease): a major international collaboration. WHO MONICA Project Principal Investigators. J Clin Epidemiol. 1988;41(2):105-114. https://doi.org/10.1016/0895-4356(88)90084-4
Bühl A, Zöfel P. Per. s nem. SPSS: iskusstvo obrabotki informatsii: analiz statisticheskikh dannykh i vosstanovlenie skrytykh zakonomernostej. M.: DiaSoft; 2005. (In Russ.).
Glantz S, Danilov YuA. Per. s angl. Mediko-biologicheskaya statistika. M.: Praktika; 1999. (In Russ.).
Cox DR. Regression Models and Life-Tables. J R Stat Soc Series B Stat Methodol. 1972;34(2):187-220.
Mallon L, Broman JE, Åkerstedt T, Hetta J. Insomnia in Sweden: A Population-Based Survey. Sleep Disord. 2014;2014:843. https://doi.org/10.1155/2014/843126
Zhang B, Wing YK. Sex differences in insomnia: a meta-analysis. Sleep. 2006;29(1):85-93. https://doi.org/10.1093/sleep/29.1.85
Barsky AJ, Peekna HM, Borus JF. Somatic symptom reporting in women and men. J Gen Int Med. 2001;16(4):266-275. https://doi.org/10.1046/j.1525-1497.2001.016004266.x
Reynolds CF, Hoch CC, Buysse DJ, et al. Electroencephalographic sleep in spousal bereavement and bereavement-related depression of late life. Biol Psychiatry. 1992;31(1):69-82. https://doi.org/10.1016/0006-3223(92)90007-m
Gianfagna F, Veronesi G, Bertù L, et al. Influence of sleep disturbances on age at onset and long-term incidence of major cardiovascular events: the MONICA-brianza and PAMELA cohort studies. Sleep Med. 2016;21: 126-132. https://dx.doi.org/10.1016/j.sleep.2016.01.007
Liu Y, Tanaka H; Fukuoka Heart Study Group. Overtime work, insufficient sleep, and risk of non-fatal acute myocardial infarction in Japanese men. Occup Environ Med. 2002;59(7):447-451. https://doi.org/10.1136/oem.59.7.447
Meisinger C, Heier M, Löwel H, et al. Sleep duration and sleep complaints and risk of myocardial infarction in middle-aged men and women from the general population: the MONICA/KORA Augsburg cohort study. Sleep. 2007;30(9):1121-1127. https://doi.org/10.1093/sleep/30.9.1121
Ramar K, Surani S. The relationship between sleep disorders and stroke. Postgrad Med. 2010;122(6):145-153. https://doi.org/10.3810/pgm.2010.11.2232
Ferré A, Sampol G, Jurado MJ, et al. Neurophysiological two-channel polysomnographic device in the diagnosis of sleep apnea. J Clin Sleep Med. 2012;15(2):163-168. https://doi.org/10.5664/jcsm.1770
Eguchi K, Hoshide S, Ishikawa S, et al. Short sleep duration is an independent predictor of stroke events in elderly hypertensive patients. J Am Soc Hypertens. 2010;4(5):255-262. https://doi.org/10.1016/j.jash.2010.09.001