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Association between sleep duration and augmentation index in post-menopausal women: A moderating role of depressive symptoms

 Ga Bin Lee  ;  Hyeon Chang Kim  ;  Sun Jae Jung 
 MATURITAS, Vol.149 : 8-15, 2021-07 
Journal Title
Issue Date
Adult ; Cohort Studies ; Cross-Sectional Studies ; Depression / epidemiology* ; Depression / psychology ; Fatigue / physiopathology* ; Female ; Humans ; Middle Aged ; Postmenopause* ; Republic of Korea / epidemiology ; Sleep Initiation and Maintenance Disorders / physiopathology* ; Surveys and Questionnaires ; Time Factors
Depressive symptoms ; Menopause ; Radial artery ; Sleep
Objectives: Physiological and psychological changes, including sleep disturbance and mood changes, frequently occur in post-menopausal women. We explored associations between sleep duration/quality and arterial stiffness, as well as the moderating role of depressive symptoms, in post-menopausal women.

Study design: This cross-sectional study utilized data obtained from 1687 post-menopausal women in the Cardiovascular and Metabolic Diseases Etiology Research Center cohort study.

Main outcome measures: Self-reported sleep was classified into short (<6 h/day), normal, and long (≥ 8 h/day) sleep durations. Poor sleep quality was operationally defined using the fatigue-related Berlin questionnaire. Depressive symptoms were assessed using the Beck Depression Index-II (BDI-II). Arterial stiffness was evaluated using the augmentation index (AI) and the HEM-9000AI system. The associations between sleep and AI were examined using generalized linear models, followed by a path model to investigate whether depressive symptoms act as an effect modifier.

Results: AI (%) values for participants with poor sleep quality were higher than those for participants with normal sleep quality (β=1.53, standard error [SE]=0.59, p = 0.009). Although overall sleep duration was not associated with AI values, the severity of depressive symptoms altered the association (p-for interaction=0.021). The magnitude of the positive association between sleep duration and AI was amplified in participants with higher BDI-II scores. In participants with severe depressive symptoms (BDI-II ≥20), a long sleep duration was significantly associated with elevated AI values (β=4.80, SE=1.56, p = 0.003) compared with those with a normal sleep duration.

Conclusion: In post-menopausal women, poor sleep quality appears to result in an increase in arterial stiffness, and depressive symptoms seem to modify the association between sleep duration and AI. This modifying role for mental health should be considered in the association between sleep and cardiovascular health in post-menopausal women.
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1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hyeon Chang(김현창) ORCID logo https://orcid.org/0000-0001-7867-1240
Jung, Sun Jae(정선재) ORCID logo https://orcid.org/0000-0002-5194-7339
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