Sleep Duration Linked to Peripheral Artery Disease Risk, Study Finds


A multinational study provides new insight into the impact of suboptimal sleep duration on risk of incident peripheral artery disease.

Shuai Yuan, PhD | Courtesy: Twitter

Shuai Yuan, PhD
Courtesy: Twitter

Poor sleep health could place individuals at an increased risk of developing peripheral artery disease (PAD), according to a new study from investigators in Sweden.

A multinational analysis, results of the study indicate people sleeping less than 5 hours per night were at a 74% greater risk of developing PAD compared to their counterparts sleeping 7-8 hours per night.

“Insufficient night-time sleep and daytime napping have previously been associated with a raised risk of coronary artery disease which, like PAD, is caused by clogged arteries,” said lead investigator Shuai Yuan, PhD, an epidemiologist in the Unit of Cardiovascular and Nutritional Epidemiology at the Karolinska Institute.2 “In addition, sleeping problems are among the top-ranked complaints in PAD patients. There are limited data on the impact of sleep habits on PAD and vice versa, and our study aimed to fill that gap.”

As the field’s understanding of the impact lifestyle risk factors have on risk of cardiovascular disease, suboptimal sleep has emerged as a major risk factor for cardiovascular conditions.3 Citing an interest in furthering the understanding of the interplay between sleep health and cardiovascular, Yuan and colleagues from the University of Pennsylvania and the Zhejiang University School of Medicine in China designed the current research endeavor as a multinational cohort and Mendelian randomization study with the intent of exploring associations between sleep duration, daytime napping, and risk of PAD.1

With this in mind, investigators then sought to replicate this in a case-control study of 28,123 PAD patients compared with a cohort of 128,459 controls obtained from the Veteran Affairs Million Veteran Program (MVP) and a cohort study of 452,028 individuals from the UK Biobank cohort. Investigators noted 2-sample Mendelian randomization was used for casual inference-based analyses of sleep-related traits and PAD from a group of 31,307 PAD cases and 211,753 controls.1

In observational analyses, results pointed to the presence of a U-shaped association between sleep duration and PAD risk. Among the cohort of Swedish adults, sleep for less than 5 hours (HR, 1.74 [95% CI, 1.31-2.31]) or sleeping for 8 or more hours (HR, 1.24 [95% CI, 1.08-1.43]) per day was associated with an increased risk of incident PAD compared to those sleep 7 to less than 8 hours per night. Investigators highlighted this finding was supported by further analyses using the MVP cohort and the UK Biobank cohort.1

Additional analysis suggested daytime napping was also associated with an increased risk of incident PAD (HR, 1.32 [95% CI, 1.18-1.49]). In Mendelian randomization analyses, results supported an inverse association between sleep duration and PAD (OR, per hour increase, 0.79 [95% CI, 0.55-0.89]) and an association between short sleep and increased PAD (OR, 1.20 [95% CI, 1.04-1.38]).1

“More research is needed on how to interrupt the bidirectional link between short sleep and PAD. Lifestyle changes that help people get more sleep, such as being physically active, may lower the risk of developing PAD. For patients with PAD, optimizing pain management could enable them to have a good night’s sleep,” Yuan added.2


  1. S Yuan, MG Levin, OE Titova, et al. Sleep duration, daytime napping, and risk of peripheral artery disease: multinational cohort and Mendelian randomization studies, European Heart Journal Open, Volume 3, Issue 2, March 2023, oead008,
  2. European Society of Cardiology. Short night-time sleep linked with nearly doubled risk of clogged leg arteries. EurekAlert! Published March 15, 2023. Accessed March 16, 2023.
  3. Iapoce C. Suboptimal sleep linked to greater likelihood of heart disease. HCP Live. Published August 25, 2022. Accessed March 16, 2023.
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