ABSTRACT
Objective
Little is known about the relationship between habitual sleep duration, cardiovascular
health (CVH) and their impact on healthcare costs and resource utilization. We describe
the relationship between sleep duration and ideal CVH, and the associated burden of
healthcare expenditure and utilization in a large South Florida employee population
free from known cardiovascular disease.
Methods
The study used data obtained from a 2014 voluntary Health Risk Assessment among 8629
adult employees of Baptist Health South Florida. Health expenditures and resource
utilization information were obtained through medical claims data. Frequencies of
the individual and cumulative CVH metrics across sleep duration were computed. Mean
and marginal per-capita healthcare expenditures were estimated.
Results
The mean age was 43 years, 57% were of Hispanic ethnicity. Persons with 6-8.9hours
and ≥9 hours of sleep were significantly more likely to report optimal goals for diet,
physical activity, body mass index, and blood pressure when compared to those who
slept less than 6 hours. Compared to those who slept less than 6 hours, those sleeping
6-8.9hours and ≥9hours had approximately 2- (odds ratio 2.1, 95% confidence interval:
1.9-3.0) and 3-times (odds ratio 3.0, 95% confidence interval: 1.6-5.6) higher odds
of optimal CVH. Both groups with 6 or more hours of sleep had lower total per-capita
expenditure (approximately $2000 and $2700 respectively), lower odds of visiting an
emergency room, or being hospitalized compared to those who slept < 6 hours.
Conclusion
Sleeping 6 or more hours was associated with better CVH, lower healthcare expenditures,
and reduced healthcare resource utilization.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Sleep Health: Journal of the National Sleep FoundationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem.National Academies Press, US)2006
- 2003 National Sleep Disorders Research Plan.Sleep. 2003; 26: 253-257
- Sleep health: can we define it? Does it matter?.Sleep. 2014; 37: 9-17
- Association of sleep duration with mortality from cardiovascular disease and other causes for Japanese men and women: the JACC study.Sleep. 2009; 32: 295-301
- Sleep duration predicts cardiovascular outcomes: a systematic review and meta-analysis of prospective studies.Eur. Heart J. 2011; 32: 1484-1492
- Association of subjective and objective sleep duration as well as sleep quality with non-invasive markers of sub-clinical Cardiovascular Disease (CVD): a systematic review.J. Atheroscler. Thromb. 2017; 24: 208-226
- Relationship between obstructive sleep apnea and coronary microcirculatory function among patients with cardiac syndrome X. Coron.Artery Dis. 2014; 25: 35-39
- Sleep duration and risk of type 2 diabetes: a meta-analysis of prospective studies.Diabetes Care. 2015; 38: 529-537
- Spending on cardiovascular disease and cardiovascular risk factors in the United States: 1996 to 2016.Circulation. 2021; 144: 271-282
- Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association.Circulation. 2021; 143: e254-e743
- Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association’s strategic impact goal through 2020 and beyond.Circulation. 2010; 121: 586-613
- A systematic review of the prevalence and outcomes of ideal cardiovascular health in US and Non-US populations.Mayo Clin. Proc. 2016; 91: 649-670
- Estimates of mortality benefit from ideal cardiovascular health metrics: a dose response meta-analysis.J. Am. Heart Assoc. 2017; 6e006904
- Favorable cardiovascular health is associated with lower healthcare expenditures and resource utilization in a large US employee population.Mayo Clin. Proc. 2017; 92: 512-524
- Favorable cardiovascular risk profile is associated with lower healthcare costs and resource utilization.Circ. Cardiovasc. Qual. Outcomes. 2016; 9: 143-153
- Cardiovascular health and healthcare utilization and expenditures among medicare beneficiaries: the REasons for Geographic And Racial Differences in Stroke (REGARDS) study.J. Am. Heart Assoc. 2017; 6e005106
- Association between sleep duration and ideal cardiovascular health among US adults, National Health and Nutrition Examination Survey, 2013-2016.Prev. Chronic. Dis. 2020; 17: E43
- Association of sleep characteristics with cardiovascular health among women and differences by race/ethnicity and menopausal status: findings from the american heart association go red for women strategically focused research network.Sleep Health. 2019; 5: 501-508
- Association of night sleep duration and ideal cardiovascular health in rural China: the Henan Rural Cohort Study.Front. Public Health. 2021; 8 (10.3389)
- Cardiovascular health and sleep disturbances in two population-based cohort studies.Heart Br. Card. Soc. 2019; 105: 1500-1506
- Workplace interventions to promote sleep health and an alert, healthy workforce.J. Clin. Sleep Med. JCSM Off. Publ. Am. Acad. Sleep Med. 2019; 15: 649-657
- Assessment of American Heart Association’s Ideal cardiovascular health metrics among employees of a large healthcare organization: the Baptist Health South Florida Employee Study.Clin. Cardiol. 2015; 38: 422-429
- Review of statistical methods for analyzing healthcare resources and costs.Health Econ. 2011; 20: 897-916
- Twopm: two-part models.Stata J. Promot. Commun. Stat. Stata. 2015; 15: 3-20
- Generalized linear models.Technometrics. 1992; 34 (2nd ed.): 223-224
- Stata Statistical Software.in: Release. 17. LLC, College Station, TX: StataCorp2021
- Long sleep duration and health outcomes: a systematic review, meta-analysis and meta-regression.Sleep Med. Rev. 2018; 39: 25-36
- Short sleep duration and dietary intake: epidemiologic evidence, mechanisms, and health implications.Adv. Nutr. Bethesda Md. 2015; 6: 648-659
- Sleep duration and body mass index and waist circumference among U.S. adults.Obes. Silver Spring Md. 2014; 22: 598-607
- Sleep duration and quality: impact on lifestyle behaviors and cardiometabolic health: a scientific statement from the American Heart Association.Circulation. 2016; 134: e367-e386
- Sleep deprivation increases blood pressure in healthy normotensive elderly and attenuates the blood pressure response to orthostatic challenge.Sleep. 2011; 34: 335-339
- A review of evidence for the link between sleep duration and hypertension.Am. J. Hypertens. 2014; 27: 1235-1242
- Associations between physical activity, sedentary time, sleep duration and daytime sleepiness in US adults.Prev. Med. 2014; 66: 68-73
- Associations between sleep disorders, sleep duration, quality of sleep, and hypertension: results from the National Health and Nutrition Examination Survey, 2005 to 2008.J. Clin. Hypertens. Greenwich Conn. 2011; 13: 739-743
- Associations between obstructive sleep apnea, sleep duration, and abnormal fasting glucose. the multi-ethnic study of atherosclerosis.Am. J. Respir. Crit. Care Med. 2015; 192: 745-753
- Short and long sleep duration associated with race/ethnicity, sociodemographics, and socioeconomic position.Sleep. 2014; 37: 601-611
- Evaluation of temporal trends in racial and ethnic disparities in sleep duration among US adults, 2004-2018.JAMA Netw. Open. 2022; 5e226385
- Social and health correlates of sleep duration in a US Hispanic population: results from the Hispanic community health study/study of Latinos.Sleep. 2015; 38: 1515-1522
- Life’s essential 8: updating and enhancing the American Heart Association’s Construct of Cardiovascular Health: a presidential advisory from the American Heart Association.Circulation. 2022; 146: e18-e43
- Workplace wellness recognition for optimizing workplace health.Circulation. 2015; 131: e480-e497
- Sleep duration and cardiovascular disease: results from the National Health Interview Survey.Sleep. 2010; 33: 1037-1042
Article info
Publication history
Published online: November 09, 2022
Accepted:
October 4,
2022
Received in revised form:
September 30,
2022
Received:
March 14,
2022
Identification
Copyright
© 2022 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.
