Reviewer ’s report  
 
Title: Relationship between sleep quality and cardiovasc ular disease risk in Chinese 
postmenopausal  women  
 
Version: 0 Date: 27 Dec 2016  
 
Reviewer: Xiaoyan Iris Leng  
 
Reviewer's report:  
 
BMWH -D-16-0018  
 
General Comments:  
 
The authors reported cross -sectional associations between sleeping quality measured by 
Pittsburgh Sleep Quality Index (PSQI) and the Framingham 10 -year risk score (FRS) based on 
BMI in a sample of 154 Chinese postmenopausal women. The data themselves are very 
interesting, however, addi tional analyses could be used to make it a more appealing paper. The 
writing of the paper could be much improved if the authors can provide more details of the 
methods and results.  
 
 
Specific Comments:  
 
1. This group of women had low rate of smoking and dia betes and had relatively low BMI. 
It seems to me that the 10 -year risk score mostly coming from SBP and hypertension 
drug use. However, description of treatment of hypertension was minimal in the paper. It 
is not clear to me whether the women was ever trea ted for hypertension or being treated 
at the time when blood pressure measures were taken. The authors should make the latter 
clarified.  
 
 
 
2. As mentioned in 1 above, since SBP and treatment of hypertension were possibly making 
the most contribution of the F RS score, it will be of interest to see how sleeping quality 
associates with SBP and treatment of hypertension (or a composite measure of both, such 
as controlled hypertension, uncontrolled hypertension, non -hypertensive)  
 
 
 
3. Descriptions of statistical ana lyses in 'methods' need to be improved. First, why would 
you test for normality for each variable? Second, for multivariable regression and logistic 
regression, the authors might want to provide what are the dependent variables and the 
independent variable s. Third, since the potential predictors were chosen based on bi -
variate analyses, the authors might want to include the methods (and results) for such 
analysis results and describe which predictors went through such process and which 
variables were exclud ed due to multicollinearity. Since the FRS was calculated based on 
age, gender, bmi, SBP and smoking status, those variables shouldn't be used as potential 
predictors again in the models. However it is not clear whether this is the case.  
 
 
 
4. Please clarify how the 154 women were chosen from the original 404 participants from 
the cohort.  
 
 
 
5. How was hypercholesterolemia determined?  
 
 
 
6. BMI categories for overweight/obese should be consistent with generally accepted 
definitions such as 25 -29 (overweight), >= 30 (obese).  
 
 
 
7. How did you choose the covariates for the logistic regression?  
 
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any st atistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statisti cs 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
 
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
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3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied f or patents relating to the content of the manuscript?  
 
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