Interplay of Short Sleep Duration and Cognitive Impairment on Cardiovascular Disease and Stroke Mortality

Experimental studies in healthy individuals have shown that sleep deprivation produces significant impairments in cognitive, cardiovascular, metabolic, and inflammatory functions. There is also growing evidence from epidemiological studies that short sleep duration is a risk factor for neurological, cardiovascular, and metabolic morbidity and mortality. However, these population-based studies have mostly relied on self-reported sleep measures and elderly cohorts and have provided inconsistent results. Importantly, the conceptual model used in previous studies has been that of short sleep duration as sole, independent predictor of cognitive impairment, cardiometabolic morbidity, or mortality. This proposal will put forward for the first time an innovative and integrated conceptual model on the role of objective sleep duration as a putative underlying mechanism involved in vascular cognitive impairment (VCI) and cardiovascular disease (CVD) and stroke mortality associated with traditional cardiometabolic risk factors in middle-age individuals from the general population. We will collect and analyze data from the Penn State Adult Cohort (PSAC), a random population-based sample of 1,741 individuals, in two phases. Phase 1 will collect cause-specific mortality data for the PSAC, and Phase 2 will perform longitudinal studies on the baseline sleep, cognitive, cardiovascular, and metabolic data in relation to the newly-collected cause-specific mortality data. Phase 1 will consist of abstraction and classification of CVD and stroke mortality data using International Classification of Disease codes. Phase 2 will consist of an analytical strategy testing 1) the role of objective sleep duration, as objectively measured with polysomnography, in predicting CVD and stroke mortality, 2) the role of objective sleep duration in predicting cognitive impairment and CVD and stroke mortality in individuals with cardiometabolic risk factors, and 3) the interplay of objective sleep duration and cognitive impairment in predicting CVD and stroke mortality. This transdisciplinary understanding of how objective sleep duration in individuals with traditional risk factors contributes to VCI and CVD and stroke mortality, will directly bridge the gap between the sleep, cognitive, and cardiovascular fields. This project will also lead to future pharmacological or behavioral studies targeting sleep in individuals with cardiometabolic risk factors in order to prevent VCI, CVD, and stroke. (AHA Program: Scientist Development Grant)