Digital health device measured sleep duration and ideal cardiovascular health: an observational study

Abstract

Background: Studies relying on self-reported sleep data suggest that there is an association between short and long sleep duration and less than ideal cardiovascular health. Evidence regarding the feasibility of using digital health devices to measure sleep duration and assess its relationship to ideal cardiovascular health are lacking. The objective of the present study was to utilize digital health devices to record sleep duration and examine the relationship between sleep duration and ideal cardiovascular health.

Methods: A total of 307 participants transmitted sleep duration data from digital health devices and answered the Life's Simple 7 survey instrument to assess ideal cardiovascular health. Sleep duration was defined as adequate (7 to < 9 h per night) or non-adequate (< 7 h and ≥ 9 h).

Results: We identified three sleep-cardiovascular health phenogroups: resilient (non-adequate sleep and ideal cardiovascular health), uncoupled (adequate sleep and non-ideal cardiovascular health) or concordant (sleep and cardiovascular health metrics were aligned). Participants in the resilient phenogroup (n = 83) had better cardiovascular health factor profiles (blood pressure, blood glucose and cholesterol levels) and behaviors (healthy weight, diet, exercise, smoking) than participants in the concordant (n = 171) and uncoupled (n = 53) phenogroups. This was associated with higher Life's Simple 7 Health Scores in the resilient phenogroup compared to the concordant and uncoupled phenogroups (7.8 ± 0.8 vs. 7.0 ± 1.4 vs. 5.6 ± 0.7, P < 0.01).

Conclusion: This study identified three distinct sleep-ideal cardiovascular health phenogroups and highlights the advantage of incorporating sleep assessments into studies of cardiovascular health. Future studies should focus on the relationship between sleep-cardiovascular phenogroups and clinical outcomes. Clinical Trial Registration Clinicaltrials.gov NCT02958098. Date of registration: November 11, 2016.

Keywords: Digital health devices; Ideal cardiovascular health; Phenogroups; Sleep; Surveys.

Conflict of interest statement

The authors declare no competing interests related to this work. The funders participated in the design of the study. The funders had no role in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

© 2021. The Author(s).

Figures

Fig. 1

Study Flowchart

Fig. 2

Relationship between sleep and cardiovascular health score to define phenogroups. Sleep duration was defined as adequate (≥ 7 to  7), intermediate (Life’s Simple 7 Health Score: > 5 to ≤ 7), or poor (≤ 5). The relationship between sleep and cardiovascular health score revealed three phenogroups: resilient, defined by ideal cardiovascular health and non-adequate sleep (n = 83); uncoupled, defined by intermediate or poor cardiovascular health, but adequate sleep (n = 53); and concordant where sleep duration and cardiovascular health measures were aligned with adequate sleep and ideal cardiovascular health or non-adequate sleep and intermediate or poor cardiovascular health (n = 171)

Fig. 3

Phenogroup differences in Life’s Simple 7 health factors and behaviors scored as ideal. The 7 health factors and behaviors categories are scored as poor, intermediate, or ideal based on pre-defined criteria. The number of health factors scored as ideal for each of the phenogroups is shown. Resilient (n = 83), Concordant (n = 171), Uncoupled (n = 53). *P < 0.01 among groups by Pearson’s chi-squared test. P < 0.01 Resilient versus Concordant, Resilient versus Uncoupled and Concordant versus Uncoupled by post-hoc Bonferroni multiple comparisons test

Fig. 4

Life’s Simple 7 Health Score calculated using self-reported data. The distribution of Life’s Simple 7 Health Scores is compared between the resilient (n = 83), concordant (n = 171), and uncoupled (n = 53) phenogroups and presented as violin plots. The median and quartiles are denoted by dashed lines. *P < 0.01 among groups by Kruskal–Wallis rank test. P < 0.01 Resilient versus Concordant, Resilient versus Uncoupled and Concordant versus Uncoupled by Dunn’s post hoc test