ArticleJournal of the American College of Cardiology2020
Sleep Irregularity and Risk of Cardiovascular Events: The Multi-Ethnic Study of Atherosclerosis.
Article in Journal of the American College of Cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 202 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
202 citing papers in PubMed, 3 syntheses or guidelines pooled it, 344 citations in OpenAlex.
- Automatic Sleep Staging Using Cardiorespiratory Signals: A Systematic Review of Methodologies and Performance.Journal of medical systems · 2026Pooled it
- Association Between Perioperative Sleep Disorders and Post-Operative Delirium in Cardiac Surgeries: A Systematic Review and Meta-Analysis.Journal of sleep research · 2026Pooled it
- 2021 ISHNE/ HRS/ EHRA/ APHRS collaborative statement on mHealth in Arrhythmia Management: Digital Medical Tools for Heart Rhythm Professionals: From the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm Association/Asia Pacific Heart Rhythm Society.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2021Guideline
- Perioperative dexmedetomidine nasal spray improves postoperative sleep in patients undergoing thoracoscopic lung surgery: a prospective, randomized controlled trial.BMC anesthesiology · 2026Trial
- Subjective and objective quality of sleep with radiant or convection cooling systems: a randomized, cross-over trial.Scientific reports · 2025Trial
- Effects of Experimental Sleep Restriction on Ambulatory and Sleep Blood Pressure in Healthy Young Adults: A Randomized Crossover Study.Hypertension (Dallas, Tex. : 1979) · 2021Trial
- Sleep duration, sleep-wake schedules, and social jetlag among corporate employees in Japan: Age- and gender-based comparisons of wearable device data (2019-2022).Preventive medicine reports · 2026Article
- Social jet lag is associated with incident cardiovascular disease independent of sleep duration and cardiac genetic risk.Journal of internal medicine · 2026Article
- Associations Between Accelerometer-Assessed Sleep Patterns, Proteomic Signatures, and Hallmarks of Aging in Adulthood.Aging cell · 2026Article
- Assessing physical activity and sleep patterns in glaucoma using wearable devices.The British journal of ophthalmology · 2026Article
- Article
- Mental health in elite athletes: International Olympic Committee consensus statement (2026).British journal of sports medicine · 2026Article
- Surgeon Social Jet Lag and Patient Risk of Major Adverse Events.JAMA surgery · 2026Article
- Circadian regulation of cardiovascular function: from physiology to clinical implications.Genome medicine · 2026Review
- Artificial intelligence-enhanced wearable technology enables ventricular arrhythmia prediction.European heart journal. Digital health · 2026Article
- Sleep and Risk for Heart Disease and Stroke.Arteriosclerosis, thrombosis, and vascular biology · 2026Review
- Acute sleep rebound following sleep restriction is associated with reduced mortality risk.Nature communications · 2026Article
- Association of Rest-Activity Rhythm and Sleep Regularity With Cardiometabolic Disease in the CARDIA Study.Journal of the American Heart Association · 2026Article
- Sex- and Ethnic Differences in the Cross-sectional Association Between Sleep Regularity and Obesity Among US Adults, NHANES 2011-2014.Journal of biological rhythms · 2026Article
- Redefining Obstructive Sleep Apnea: Multidimensional Phenotyping Beyond the Apnea-Hypopnea Index.Pathophysiology : the official journal of the International Society for Pathophysiology · 2026Review
142 more citing papers are in PubMed but not listed here.
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe cardiovascular system exhibits strong circadian rhythms to maintain normal functioning. Irregular sleep schedules, characterized by high day-to-day variability in sleep duration or timing, represent possibly milder but much more common and chronic disruption of circadian rhythms in the general population than shift work.
objectivesThis study aimed to prospectively examine the association between sleep regularity and risk of cardiovascular disease (CVD).
methodsIn MESA (Multi-Ethnic Study of Atherosclerosis), 1,992 participants free of CVD completed 7-day wrist actigraphy for sleep assessment from 2010 to 2013 and were prospectively followed through 2016. The study assessed sleep regularity using the SD of actigraphy-measured sleep duration and sleep-onset timing across 7 days. Incident CVD included nonfatal and fatal cardiovascular events. A Cox proportional hazards model was used to estimate hazard ratios (HRs) for incident CVD according to SD of sleep duration and timing, adjusted for traditional CVD risk factors (including CVD biomarkers) and other sleep-related factors (including average sleep duration).
resultsDuring a median follow-up of 4.9 years, 111 participants developed CVD events. The multivariable-adjusted HRs (95% confidence intervals) for CVD across categories of sleep duration SD were 1.00 (reference) for ≤60 min, 1.09 (0.62 to 1.92) for 61 to 90 min, 1.59 (0.91 to 2.76) for 91 to 120 min, and 2.14 (1.24 to 3.68) for >120 min (p trend = 0.002). Similarly, compared with participants with a sleep timing SD ≤30 min, the HRs (95% confidence intervals) for CVD were 1.16 (0.64 to 2.13) for 31 to 60 min, 1.52 (0.81 to 2.88) for 61 to 90 min, and 2.11 (1.13 to 3.91) for >90 min (p trend = 0.002). Exclusion of current shift workers yielded similar results.
conclusionsIrregular sleep duration and timing may be novel risk factors for CVD, independent of traditional CVD risk factors and sleep quantity and/or quality.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.