Abstract MP60: Sleep Fragmentation, Sleep Medications, And Incident Heart Failure And Subtypes In Post-menopausal Women

• Published in: Circulation (New York, N.Y.) N.Y.), 2022-03, Vol.145 (Suppl_1)
• Main Authors: Moafi-Madani, Miremad, Stephens, Michael, Roberts, Mary, Eaton, Charles
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.145.suppl_1.MP60

Abstract only Background: Women, specifically post-menopausal women, have poorer sleep quality and an increased risk for insomnia relative to men. Insomnia is more prevalent among patients with heart failure, and prior research has shown a dose-dependent association between the severity of insomnia and the risk of heart failure. However, it is unclear which aspects of insomnia are most associated with heart failure, and whether any associations exist between sleep medication use and incident heart failure subtypes. Methods: This is a prospective cohort study of 42,832 post-menopausal women from the Women’s Health Initiative (WHI). Insomnia was assessed using the validated WHI Insomnia Rating Scale (WHIIRS) which includes sleep fragmentation, trouble falling asleep, waking up early, difficulty in falling back asleep upon waking up, and perceived sleep quality. Sleep medication use was asked and arranged into three categories. Association between insomnia components and sleep medication use and incident HF and its subtypes were evaluated using Cox proportional hazard models. Results: In our multivariable-adjusted model, Sleep fragmentation for more than two nights per week is associated with incident overall HF (HR=1.32, 95% CI: 1.19 - 1.46) and HFpEF (HR=1.43, 95% CI: 1.24 - 1.65). Sleep medications use for more than two nights per week was associated with HF (HR=1.46, 95% CI: 1.28 - 1.67), HFpEF (HR=1.40, 95% CI: 1.16- 1.68), and HFrEF (HR=1.44, 95% CI: 1.12 - 1.85). There were no significant associations between HF and the remaining insomnia components. Conclusions: In postmenopausal women, sleep fragmentation is associated with an increased risk of incident HF and HFpEF. Sleep medication use for more than two nights per week is associated with an increased risk of incident HF, HFpEF, and HFrEF among postmenopausal women. Whether interventions to decrease the frequency of sleep fragmentation and sleep medication use in older adults will reduce HF risk warrants further study.