Nine out of ten people do not sleep well at night, according to research presented at the ESC 2022 Congress.1 The study found that suboptimal sleep was associated with a higher chance of heart disease and stroke. The authors estimated that seven out of ten of these cardiovascular conditions could be prevented if everyone got a good night’s sleep.
“The low prevalence of good sleepers was expected given our busy 24/7 lives,” said study author Dr. Aboubakari Nambiema, of INSERM (the French National Institute of Health and Medical Research), in Paris, France. “The importance of sleep quality and quantity for heart health needs to be taught early in life when healthy behaviors are established. Minimizing noise at night and stress at work can help improve sleep.”
Previous studies of sleep and heart disease have generally focused on a sleep pattern, such as sleep duration or sleep apnea, where breathing stops and starts while sleeping. Also, previous studies have often assessed sleep only at baseline. The current study used a healthy sleep score that combined five sleep habits. The researchers investigated the association between baseline sleep score and changes over time in sleep score and incident cardiovascular disease.
This study included 7200 participants from the Paris Prospective Study III (PPP3), a community-based prospective observational cohort. Men and women aged 50 to 75 years free of cardiovascular disease were recruited at a preventive medical center between 2008 and 2011. The average age was 59.7 years and 62% were men. Participants underwent a physical exam and completed questionnaires about lifestyle, personal and family medical history, and medical conditions.
Questionnaires were used to collect information on five sleep habits at baseline and two follow-up visits. Each factor received 1 point if it was optimal and 0 if it was not. A healthy sleep score ranging from 0 to 5 was calculated, with 0 or 1 considered poor and 5 considered optimal. Those with an optimal score reported sleeping 7 to 8 hours a night, never or rarely having insomnia, no frequent excessive daytime sleepiness, no sleep apnea, and an early chronotype (being a morning person). The researchers reviewed incidents of coronary heart disease and stroke every two years for a total of 10 years.
At the start of the study, 10% of participants had an optimal sleep score and 8% had a poor score. During a median follow-up of eight years, 274 participants developed coronary heart disease or stroke. The researchers looked at the association between sleep scores and cardiovascular events after adjusting for age, sex, alcohol use, occupation, smoking, body mass index, physical activity, cholesterol level, diabetes, and family history of heart attack. stroke or sudden cardiac death. They found that the risk of coronary heart disease and stroke decreased by 22% for every 1-point increase in sleep score at baseline. More specifically, compared to those with a score of 0 or 1, participants with a score of 5 had a 75% lower risk of heart disease or stroke.
The researchers calculated the proportion of cardiovascular events that could be prevented by healthier sleep. They found that if all participants had an optimal sleep score, 72% of new cases of coronary heart disease and stroke could be prevented each year.
Over two follow-ups, almost half of the participants (48%) changed their sleep score: 25% decreased while 23% improved. When the researchers examined the association between score change and cardiovascular events, they found that a 1-point increase over time was associated with a 7% reduction in risk of coronary heart disease or stroke.
Dr Nambiema said: “Our study illustrates the potential of good sleep to preserve heart health and suggests that improved sleep is linked to lower risks of coronary heart disease and stroke. We also found that the vast majority of people have difficulty With cardiovascular disease being the leading cause of death worldwide, greater awareness of the importance of getting a good night’s sleep to maintain a healthy heart is needed.”
1The abstract “Scoring Healthy Sleep and Incident Cardiovascular Disease: Paris Prospective Study III (PPS3)” will be presented during the Sleep Disorders and Apnea, Physical Inactivity session on Saturday 27 August from 14:15 to 15:00 CEST at the Station 4.