Increased Rapid Eye Movement Sleep Is Associated With a Reduced Risk of Heart Failure in Middle-Aged and Older Adults

Binbin Zhao; Xiaoying Jin; Jian Yang; Qingyan Ma; Zai Yang; Wei Wang; Ling Bai; Xiancang Ma; Bin Yan

doi:10.3389/fcvm.2022.771280

Increased Rapid Eye Movement Sleep Is Associated With a Reduced Risk of Heart Failure in Middle-Aged and Older Adults

Front Cardiovasc Med. 2022 Mar 29:9:771280. doi: 10.3389/fcvm.2022.771280. eCollection 2022.

Authors

Binbin Zhao¹, Xiaoying Jin¹, Jian Yang^{1

2}, Qingyan Ma¹, Zai Yang¹, Wei Wang¹, Ling Bai^{2

3}, Xiancang Ma¹, Bin Yan^{1

2}

Affiliations

¹ Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
² Department of Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
³ Department of Cardiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

Abstract

Objectives: Rapid eye movement (REM) sleep is closely related to all-cause mortality. The aim of this study is to explore the role of REM sleep on the incident heart failure (HF).

Methods: We selected 4490 participants (2480 women and 2010 men; mean age, 63.2 ± 11.0 years) from the Sleep Heart Health Study. HF was identified as the first occurrence during a mean follow-up period of 10.9 years. REM sleep including percentage of REM sleep and total REM sleep time were monitored using in-home polysomnography at baseline. Multivariable Cox regression analysis was utilized to explore the relationship between REM sleep and HF.

Results: In total, 436 (9.7%) cases of HF were observed during the entire follow-up period. After adjusting for potential covariates, an increased percentage of REM sleep (per 5%) was independently associated with a reduced incidence of HF [hazard ratio (HR) 0.88, 95% confidence interval (CI) 0.82-0.94, P < 0.001]. A similar result was also found between total REM sleep time (increased per 5 min) and incident HF (HR 0.97, 95% CI 0.95-0.99, P < 0.001). Moreover, the fourth quartile of both percentage of REM sleep (HR 0.65, 95% CI 0.48-0.88, P = 0.005) and total REM sleep time (HR 0.64, 95% CI 0.45-0.90, P = 0.010) had lower risk of incident HF when compared with the first quartile.

Conclusion: An increased percentage of REM sleep and total REM sleep time were associated with a reduced risk of HF. REM sleep may be a predictor of the incident HF.

Clinical trial registration: [ClinicalTrials.gov], identifier [NCT00005275].

Keywords: heart failue; percentage of REM sleep; polysomnography; sleep heart health study; total REM sleep time.

Associated data

ClinicalTrials.gov/NCT00005275