ArticleCirculation2024
Trajectories of Sleep Over Midlife and Incident Cardiovascular Disease Events in the Study of Women's Health Across the Nation.
Article in Circulation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 1 of them a synthesis that pooled it.
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Who cites it
42 citing papers in PubMed, 1 synthesis or guideline pooled it, 57 citations in OpenAlex.
- Efficacy of auriculotherapies for primary insomnia: A systematic review and network meta-analysis.Medicine · 2026Pooled it
- Association of long-term depressive burden with incident cardiometabolic multimorbidity: a prospective study in middle-aged and older adults across three continents.Journal of global health · 2026Article
- Article
- Modeling the Exposome in Murine Cardiovascular Disease.JACC. Basic to translational science · 2026Review
- Midlife Sleep and Circadian Health: Implications for Cardiovascular and Cognitive Outcomes.Obstetrics and gynecology clinics of North America · 2026Review
- Insomnia and Cardiovascular Disease: Untangling a Complex Relationship.Journal of sleep research · 2026Review
- Insomnia symptoms in women and men after percutaneous coronary intervention - a prospective multicentre cohort study.Journal of patient-reported outcomes · 2026Observational
- Sleep Duration and Mortality in Women: Effect of Aging and Menopause.Sleep medicine clinics · 2026Review
- Joint trajectories of sleep duration and depressive symptoms and risk of incident multimorbidity: a longitudinal analysis with machine learning prediction.BMC geriatrics · 2026Article
- Article
- Cognitive behavioral therapy for menopausal insomnia in perimenopausal and postmenopausal women with insomnia and nocturnal hot flashes: a randomized-controlled pilot trial.Menopause (New York, N.Y.) · 2026Article
- Insomnia and Incident Cardiovascular Disease in US Hispanic/Latino Adults: Results From HCHS/SOL.Journal of the American Heart Association · 2026Article
- The association between sleep disorders and the risk of atherosclerotic cardiovascular disease: regression analysis and neural network prediction based on NHANES data.Journal of cardiothoracic surgery · 2026Article
- Impact of nighttime sleep duration and daytime nap combinations on cardiovascular disease risk in middle-aged and older Chinese adults: a nationwide prospective cohort study.BMC public health · 2026Article
- The association between obstructive sleep apnea risk and cardiovascular disease risk in midlife Thai women in the U.S.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026Article
- Article
- Study on diagnostic models for insomnia and gastralgia with Liver-Spleen Disharmony Syndrome based on machine learning.Frontiers in medicine · 2026Article
- External factors show reproducible local symptom-biomarker associations in middle-aged and older adults with heart disease.Frontiers in psychiatry · 2026Article
- Latent profile analysis and influencing factors of sleep quality in community perimenopausal women: a cross-sectional study.BMC women's health · 2025Article
- Sleep Quality and Outcomes in Preclinical Heart Failure: A Prospective UK Biobank Cohort Study.The American journal of medicine · 2025Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundUp to 50% of women report sleep problems in midlife, and cardiovascular disease (CVD) is the leading cause of death in women. How chronic poor sleep exposure over decades of midlife is related to CVD risk in women is poorly understood. We tested whether trajectories of insomnia symptoms or sleep duration over midlife were related to subsequent CVD events among SWAN (Study of Women's Health Across the Nation) participants, whose sleep was assessed up to 16 times over 22 years.
methodsAt baseline, SWAN participants (n=2964) were 42 to 52 years of age, premenopausal or early perimenopausal, not using hormone therapy, and free of CVD. They completed up to 16 visits, including questionnaires assessing insomnia symptoms (trouble falling asleep, waking up several times a night, or waking earlier than planned ≥3 times/week classified as insomnia), typical daily sleep duration, vasomotor symptoms, and depressive symptoms; anthropometric measurements; phlebotomy; and CVD event ascertainment (ie, fatal or nonfatal myocardial infarction, stroke, heart failure, revascularization). Sleep trajectories (ie, insomnia, sleep duration) were determined by means of group-based trajectory modeling. Sleep trajectories were tested in relation to CVD in Cox proportional hazards models (multivariable models: site, age, race and ethnicity, education, CVD risk factors averaged over visits; additional covariates: vasomotor symptoms, snoring, depression).
resultsFour trajectories of insomnia symptoms emerged: low insomnia symptoms (n=1142 [39% of women]), moderate insomnia symptoms decreasing over time (n=564 [19%]), low insomnia symptoms increasing over time (n=590 [20%]), and high insomnia symptoms that persisted (n=668 [23%]). Women with persistently high insomnia symptoms had higher CVD risk (hazard ratio, 1.71 [95% CI, 1.19, 2.46],
conclusionsInsomnia symptoms, when persistent over midlife or occurring with short sleep, are associated with higher CVD risk among women.
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