Poor Sleep Linked to Increased Risk of Cardiovascular Disease in Middle Adulthood

Poor sleep health was associated with an increased risk of cardiovascular disease (CVD) in middle adulthood, according to a recent study published in Scientific Reports.

The University of South Florida-led study found that for each component (regularity, satisfaction, alertness, efficiency, duration, and sleep actigraphy) of a composite sleep health measure, participants experienced an incrementally larger risk for CVD compared with those with healthy sleep.

"Insufficient or poor sleep is a significant risk factor for heart disease. Studies have mostly used single sleep measures (often focusing only on sleep duration, quality, or insomnia). However, a composite of multidimensional sleep health may be more predictive of heart disease than single sleep measures,” wrote authors led by Soomi Lee, PhD, assistant professor, College of Behavioral and Community Sciences, University of South Florida School of Aging Studies. "Our approach lends itself to characterizing a ‘sleep health’ message that will be more effective in motivating the public to engage in multiple sleep health behaviors that may have synergistic effects on decreasing the risk of heart disease.”

Lee and colleagues reviewed sleep data of 6820 adults (mean age, 53 years) from the Midlife in the United States study to examine whether subjectively and objectively measured sleep health composites are associated with CVD. Among all participants, 633 provided actigraphy sleep data.

Investigators assessed 2 sleep health composites: the first (based on self-report only) assessed regularity, satisfaction, alertness, efficiency, and duration of sleep; the second was based on each of the previous self-reported variables plus sleep actigraphy.

Participants were asked if they had a history of physician-confirmed cardiovascular conditions such as myocardial infarction, arrhythmia, congestive heart failure, or coronary heart disease. Researchers excluded hypertension as a sleep health-related CVD and controlled for family history of CVD and sociodemographic factors (eg, race, sex, smoking, depression, and exercise).

After full adjustment, researchers observed a significant association of the self-report sleep health composite with the risk of CVD. Each unit increase in poor sleep health was associated with 54% higher risk of CVD (adjusted relative risk [aRR], 1.54; P<.001). For the actigraphy plus self-report sleep health composite, each unit increase in poor sleep health was associated with 141% higher risk of CVD (aRR, 2.41; P<.001), according to the study.

The team noted that while women reported having more sleep health problems, men were more likely to suffer CVD, but gender did not impact the overall correlation between the 2 factors.

Also, non-Hispanic Black participants had more sleep health problems and a higher prevalence of CVD than White participants and participants of other races (eg, Asian, Native American, Hispanic), but the “link between sleep health and heart disease was not moderated by sex,” wrote authors.

“These findings show the importance of assessing ‘co-existing sleep health problems’ within an individual to capture the risk of heart disease. This is one of the first studies showing that, among well-functioning adults in midlife, having more sleep health problems may increase the risk of heart disease,” said Lee in a University of South Florida press release. “The higher estimated risk in those who provided both self-report and actigraphy sleep data suggests that measuring sleep health accurately and comprehensively is important to increase the prediction of heart disease.”

Reference: Lee S, Mu CX, Wallace ML, et al. Sleep health composites are associated with the risk of heart disease across sex and race. Sci Rep. 2022;12:2023.