ABC | Volume 112, Nº6, June 2019

Letter to the Editor Oliveira et al Sleep disorders impair cardiovascular health Arq Bras Cardiol. 2019; 112(6):807-808 Reply We appreciate the interest in our study. We agree with our readers that sleeping disorders may play a role in the association between job strain and cardiovascular health. Sleep apnea has a prevalence of 35% among those with overweight. 1 In our sample, more than 65% had BMI > 25 kg/m 2 , suggesting a high prevalence of sleep apnea and probably a high influence in job stress. Although sleep apnea screening using questionnaires or polysomnography was not performed in our study, we asked the participants whether they had sleeping disturbances in the previous weeks due to any concerns at the workplace. We found that those with high job strain were more likely to answer “yes” to this question than other participants (40% vs 21%, p < 0.001), suggesting that a low sleep quality was more prevalent among those with high job strain. Therefore, future studies should evaluate whether sleep disturbances can explain the association between job strain and cardiovascular health. In accordance with our readers, we propose a strategy to promote a healthy lifestyle that would encompass a sleep awareness campaign, including promotion of sleep hygiene and also questionnaires to screen for sleep apnea. In addition, programs to control obesity would help to improve sleep quality, because it has been proved to reduce the apnea-hypopnea index in subjects with sleep apnea. 2 In conclusion, strategies that include sleep awareness may help improve the impact on cardiovascular health. Davi Dantas Muniz Miguel Morita Fernandes-Silva Odilson Marcos Silvestre 1. Romero-Corral A, Caples SM, Lopez-Jimenez F, Somers VK. Interactions between obesity and obstructive sleep apnea: implications for treatment. Chest. 2010;137(3):711–9 2. Smith PL, Gold AR, Meyers DA, Haponik EF, Bleecker ER. Weight loss in mildly tomoderately obese patients with obstructive sleep apnea. Ann Intern Med. 1985;103(6 Part 1):850-5. References This is an open-access article distributed under the terms of the Creative Commons Attribution License 808