Short sleep duration in adults with congenital heart disease is associated with epicardial adipose tissue accumulation

Britta Stapel^1*Lotta Winter¹Ivo Heitland¹Tim Halling¹Steffen Akkermann¹Jochen Muke²Friederike Löffler¹Johann Bauersachs¹Mechthild Westhoff-Bleck¹Kai G. Kahl¹

• ¹Hannover Medical School, Hanover, Germany
• ²European Medical School Oldenburg-Groningen (EMS), University of Oldenburg, Oldenburg, Lower Saxony, Germany

Abstract Short sleep duration has been linked to heightened risk for cardiometabolic disorders and adverse outcomes, including hospitalization and mortality, in patients with cardiovascular disease (CVD). We assessed the association of sleep duration and cardiovascular parameters in adults with congenital heart disease (ACHD). Data were derived from the ongoing PSYConHEART study on morbidity and mortality factors in ACHD. Sleep duration, socio-demographic variables, and anxiety and depression were determined using self-report questionnaires. Epicardial adipose tissue (EAT) was measured by echocardiography and clinical parameters regarding the underlying heart condition, including serum levels of N-terminal-pro-B-type natriuretic peptide (NT-proBNP), were assessed. Patients with a score < 3 on the Hospital Anxiety and Depression Scale depression subscale were included (N=194). Short sleep duration (≤ 6 h/night) was present in N=48 patients (25%). Two-way multivariate analysis with sleep duration (≤ 6 h/night vs > 6 h/night) and age (≥ 35 vs < 35 years) as independent variables, corrected for BMI, sex, and NYHA class, revealed a significant effect of sleep duration and age on prognostic CVD markers, i.e. EAT and NT-proBNP. Sleep duration was associated with CVD markers in older patients only. Sleep duration is associated with prognostic markers for CVD in older ACHD patients. Particularly EAT, which has prognostic value in cardiac diseases was negatively impacted by short sleep duration. Sleep problems/disorders are amenable to psychological and pharmacological interventions. Assessment of sleep problems/disorders may be recommended in multimodal treatment of ACHD patients.