The new findings suggest that suboptimal sleep was associated with a higher likelihood of heart disease and stroke, with a higher healthy sleep score linked to lower risk.
The data suggests that nine out of ten patients do not sleep well at night, and the researchers estimate that 7 out of 10 of these cardiovascular conditions could be prevented with adequate sleep.
“Our study illustrates the potential of good sleep to preserve heart health and suggests that improved sleep is associated with lower risks of coronary heart disease and stroke,” said study senior author Aboubakari Nambiema, PhD, MPH, INSERM. “We also found that the vast majority of people have difficulty sleeping. With cardiovascular disease being the leading cause of death worldwide, greater awareness of the importance of good sleep to maintain a healthy heart is needed.”
The data was presented at the 2022 European Society of Cardiology Congress in Barcelona, Spain.
Most studies investigating the association between sleep habits and CVD have focused on a single dimension of sleep, such as sleep duration and sleep apnea, often measuring sleep only at baseline. Nambiema and her colleagues examined the association between baseline sleep score and changes over time in sleep score and incident cardiovascular disease.
The study included 7,200 participants from the community-based, prospective observational study, Paris Prospective Study III. The researchers recruited men and women aged 50 to 75 years and free of CVD at a preventive medical center between 2008 and 2011.
Each had undergone a standard physical examination and standard biological tests and were asked to provide information on lifestyle, personal and family medical history, current health status, and medication use.
Participants’ sleep habits were self-reported on validated questionnaires at baseline and at two follow-up visits. Sleep dimensions were assigned a single point if optimal and a zero point otherwise. The researchers calculated a healthy sleep score from 0 to 5 and reflected the number of optimal sleep dimensions.
Dimensions included early chronotype, sleep duration 7 to 8 hours per day, never or rarely insomnia, no sleep apnea, and no frequent excessive daytime sleepiness. In addition, the researchers monitored the incidence of coronary heart disease and stroke every two years for a total of 10 years.
At baseline, the study included 7,203 participants (62% men; mean age, 59.7 years) who considered themselves free of CVD and had complete data on sleep patterns and covariates. The data shows that 10% of the participants had an optimal sleep score (5) and 8% had a poor score (0 or 1).
During a median follow-up of 8 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, gender, alcohol use, occupation, smoking, body mass index, physical activity, cholesterol level, diabetes, and family history of heart disease.
They found that the risk of coronary heart disease and stroke decreased by 22% (HR, 0.78 [95% confidence interval, CI; 0.71 – 0.86]) for each 1-point increase in sleep score at baseline. The data also suggests that participants with a score of 5 had a 75% lower risk of heart disease or stroke, compared to those with a score of 0 or 1.
With healthier sleep and an optimal sleep score, the researchers determined that 72% of new cases of coronary heart disease and stroke could be prevented each year.
Then, over two follow-ups, the data suggests that 48% of participants were able to change their sleep score (25% decreased; 23% improved). Regarding the association between change in score and cardiovascular events, they found that an increase of 1 point over time was associated with a 7% reduction in the risk of cardiovascular events.
“The low prevalence of good sleepers was expected given our busy 24/7 lives,” Nambiema added. “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.”
The abstract, “Healthy Sleep Score and Incident Cardiovascular Disease: Paris Prospective Study III (PPS3),” was presented at CES 2022.