Association Between Sleep Duration and Angina Characteristics in United States Adults

ABSTRACT: Background: Sleep is now recognized as a key factor in cardiovascular health by the American Heart Association's Life’s Essential 8. However, the relationship between sleep duration and stable angina remains unexplored. Methods: This nationally representative cross-sectional study an...

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Main Authors: Maslahuddin HA Alhaque Roomi, MD, Nehal Eid, MBBCh, Aayush Visaria, MD
Format: Article
Language:English
Published: Elsevier 2025-12-01
Series:American Journal of Medicine Open
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Online Access:http://www.sciencedirect.com/science/article/pii/S2667036425000238
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author Maslahuddin HA Alhaque Roomi, MD
Nehal Eid, MBBCh
Aayush Visaria, MD
author_facet Maslahuddin HA Alhaque Roomi, MD
Nehal Eid, MBBCh
Aayush Visaria, MD
author_sort Maslahuddin HA Alhaque Roomi, MD
collection DOAJ
description ABSTRACT: Background: Sleep is now recognized as a key factor in cardiovascular health by the American Heart Association's Life’s Essential 8. However, the relationship between sleep duration and stable angina remains unexplored. Methods: This nationally representative cross-sectional study analyzed data from 18,385 U.S. adults aged 40 and older using the National Health and Nutrition Examination Survey (2005-2018). Daily sleep duration was categorized as <7 hours, 7-8 hours (reference), and >8 hours. Angina was assessed with the Rose Angina Questionnaire and classified by severity (Grade 1 or 2) and pain location (typical vs atypical). Covariates were identified a priori based on previous literature, and clinical relevance. Results: Our study included 18,385 adults with a mean age of 57.6 years (SE 0.16). Out of these, 48.6% were female and 70% were non-Hispanic Whites. A total of 954 (5.2 %) participants reported experiencing angina. Among those with angina, 109 (11%) reported atypical symptoms. Univariate analysis revealed that both short (<7 hours) and long (>8 hours) sleep durations were associated with higher odds of Grade 2 angina compared to adequate sleep (7-8 hours). Adjusted analysis showed significantly higher odds of Grade 2 angina in individuals sleeping >8 hours (OR [95% CI]: 2.16 [1.08-4.32] for females; 2.69 [1.15-6.29] for males). Additionally, sleep <7 hours was associated with a greater likelihood of atypical angina presentation (OR: 1.77 [1.21-3.05]). Conclusion: Our findings suggest that sleeping over 8 hours increases the likelihood of Grade 2 angina, while under 7 hours is linked to atypical presentations, complicating diagnosis. Clinicians could incorporate brief sleep assessments—asking about duration and quality—alongside angina tools like the ROSE questionnaire to identify potential sleep-related factors. While promising, these associations require further research before being translated into definitive clinical guidelines for angina management.
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spelling doaj-art-e303a4a4cdb14fcaaf7fd96cd6d3e0602025-08-20T02:39:41ZengElsevierAmerican Journal of Medicine Open2667-03642025-12-011410010910.1016/j.ajmo.2025.100109Association Between Sleep Duration and Angina Characteristics in United States AdultsMaslahuddin HA Alhaque Roomi, MD0Nehal Eid, MBBCh1Aayush Visaria, MD2Mercy Catholic Medical Center, Pennsylvania, USA; Requests for reprints should be addressed to Maslahuddin HA Alhaque Roomi, MD, Internal Medicine, Dr. Baba Saheb Ambedkar Medical College and Hospital Sector 6 Rd, near Metro Station, Sector 6, Rohini, New Delhi, Delhi 110085.Mansoura Manchester Medical Program, El Mansoura, EgyptRutgers Robert Wood Johnson Medical School, New Jersey, USAABSTRACT: Background: Sleep is now recognized as a key factor in cardiovascular health by the American Heart Association's Life’s Essential 8. However, the relationship between sleep duration and stable angina remains unexplored. Methods: This nationally representative cross-sectional study analyzed data from 18,385 U.S. adults aged 40 and older using the National Health and Nutrition Examination Survey (2005-2018). Daily sleep duration was categorized as <7 hours, 7-8 hours (reference), and >8 hours. Angina was assessed with the Rose Angina Questionnaire and classified by severity (Grade 1 or 2) and pain location (typical vs atypical). Covariates were identified a priori based on previous literature, and clinical relevance. Results: Our study included 18,385 adults with a mean age of 57.6 years (SE 0.16). Out of these, 48.6% were female and 70% were non-Hispanic Whites. A total of 954 (5.2 %) participants reported experiencing angina. Among those with angina, 109 (11%) reported atypical symptoms. Univariate analysis revealed that both short (<7 hours) and long (>8 hours) sleep durations were associated with higher odds of Grade 2 angina compared to adequate sleep (7-8 hours). Adjusted analysis showed significantly higher odds of Grade 2 angina in individuals sleeping >8 hours (OR [95% CI]: 2.16 [1.08-4.32] for females; 2.69 [1.15-6.29] for males). Additionally, sleep <7 hours was associated with a greater likelihood of atypical angina presentation (OR: 1.77 [1.21-3.05]). Conclusion: Our findings suggest that sleeping over 8 hours increases the likelihood of Grade 2 angina, while under 7 hours is linked to atypical presentations, complicating diagnosis. Clinicians could incorporate brief sleep assessments—asking about duration and quality—alongside angina tools like the ROSE questionnaire to identify potential sleep-related factors. While promising, these associations require further research before being translated into definitive clinical guidelines for angina management.http://www.sciencedirect.com/science/article/pii/S2667036425000238Sleep durationAnginaCross-SectionalNHANES
spellingShingle Maslahuddin HA Alhaque Roomi, MD
Nehal Eid, MBBCh
Aayush Visaria, MD
Association Between Sleep Duration and Angina Characteristics in United States Adults
American Journal of Medicine Open
Sleep duration
Angina
Cross-Sectional
NHANES
title Association Between Sleep Duration and Angina Characteristics in United States Adults
title_full Association Between Sleep Duration and Angina Characteristics in United States Adults
title_fullStr Association Between Sleep Duration and Angina Characteristics in United States Adults
title_full_unstemmed Association Between Sleep Duration and Angina Characteristics in United States Adults
title_short Association Between Sleep Duration and Angina Characteristics in United States Adults
title_sort association between sleep duration and angina characteristics in united states adults
topic Sleep duration
Angina
Cross-Sectional
NHANES
url http://www.sciencedirect.com/science/article/pii/S2667036425000238
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