3E-04 - Circadian Rhythms and Cardiovascular Integrity: Unveiling the Influence of Sleep Patterns on Aortic Aneurysm and Dissection in the UK Biobank Cohort

Background: Aortic aneurysm and dissection (AAD) are severe, life-threatening cardiovascular diseases(CVD). Sleep is a modifiable health behavior, with numerous studies indicating its influence on CVD. However, the relationship between sleep patterns and the risk of AAD remains unexplored. The research aims to investigate the effects of different sleep patterns on the occurrence of AAD.

Objectives: This prospective cohort study hypothesized that unhealthy sleep patterns contribute to increased AAD risk. Using sleep data from accelerometers in the UK Biobank, we examined the association between sleep patterns and AAD, conducting subgroup analysis to test result stability.

Methods: This is a prospective cohort study using data from the UK Biobank, analyzing the association between sleep patterns and AAD risk. Cox proportional hazards models were used to estimate hazard ratios, adjusting for demographic, lifestyle, and health factors. Data from 88,461 participants who wore wrist-worn accelerometers from 2013-2015 were included. Participants were followed until the first occurrence of AAD, death, or study end (November 2021). Sleep data, including duration, onset time, rhythm, and segments, were derived from accelerometer measurements and processed using GGIR software. The primary outcome was the first occurrence of AAD, identified by ICD-10 (I71) and ICD-9 (441) codes. Cox models were adjusted for confounding variables. Multiple imputations handled missing data, and sensitivity analyses assessed robustness. Subgroup analyses were conducted based on sex, age, smoking history, and baseline health conditions.

Results: A total of 87,785 participants were included, with a median follow-up of 7 years, recording 411 cases of AAD. Shorter sleep duration and later sleep onset were associated with an increased risk of AAD. Sleeping less than 6 hours increased the risk by 48% (HR = 1.48, 95% CI: 1.13–1.94, P = 0.004), and sleeping after 00:30 further raised the risk (HR = 1.70, 95% CI: 1.21–2.40, P = 0.003). In subgroup analyses, the effects were stronger in females: those with less than 6 hours of sleep had an HR of 3.04 (95% CI: 2.07–4.48, P < 0.001), and those falling asleep after 00:30 had an HR of 3.12 (95% CI: 2.10–4.65, P < 0.001). Sensitivity analyses confirmed these results, showing consistent HR for both sleep duration and onset time across different follow-up and data conditions.

Conclusions: Sleep quality and rhythm did not significantly impact the occurrence of AAD. However, both shorter sleep duration and later sleep onset were associated with an increased risk of AAD. Sleep patterns may thus serve as important modifiable factors for AAD and CVD prevention.