Better sleep may improve heart health: American Heart Association

A group of researchers at Columbia University’s Mailman School of Public Health evaluated the American Heart Association’s recently expanded metric — which now includes sleep as it relates to cardiovascular disease risk. 

The study published in the Journal of the American Heart Association provided evidence that sleep plays an important role when it comes to heart health. 

 “Our results show that sleep health is integral to heart health, and that an expanded definition of cardiovascular health that includes sleep is more predictive of future heart disease risk,” lead study author Nour Makarem, PhD, an assistant professor of epidemiology at the Mailman School of Public Health at Columbia University in New York City, told Fox News Digital.

“Our study supports the inclusion of sleep as the novel 8th metric of cardiovascular health,” Makarem also said.

The study represents the first examination of adding sleep to the American Heart Association’s original Life’s Simple 7 metrics as a novel 8th metric of cardiovascular health, the study author said. 

Sleep was recently added to the American Heart Association’s Life’s Simple 7 measures, a checklist-type of scoring tool used to assess an individual’s cardiovascular health risk. 

The new sleep metric suggests 7-9 hours of sleep daily for optimal cardiovascular health for adults, and more for children depending on age, according to the American Heart Association’s statement about the revised metrics. 

The previous checklist included measures such as nicotine exposure, physical activity, diet, weight, blood glucose, cholesterol and blood pressure.  

The tool that includes sleep is now referred to as the Life’s Essential 8.™

The Columbia University researchers, deciding to evaluate the expanded measure, looked at approximately 2,000 middle-aged-to-older adults from the Multi-Ethnic Study of Atherosclerois (MESA), a U.S. study of cardiovascular disease and its risk factors.

The participants provided data on their sleep characteristics and took part in a sleep exam, according to the news release from Columbia University.

The investigators examined cardiovascular health scores that included the original American Heart Association’s Life’s Simple 7 (LS7) metrics, along with different sleep health measures to determine the sleep parameters that should be a priority for preventing cardiovascular disease. 

Cardiovascular health scores that looked at different dimensions of sleep such as sleep duration, efficiency, sleep regularity, sleep disorders and daytime sleepiness — as well as cardiovascular health scores that included duration of sleep only as a measure of sleep health — were both predictive of cardiovascular disease (CVD), the researchers found.

The study found that sleeping 7 hours or more but less than 9 hours each night was considered indicative of ideal sleep health.

“Our results demonstrate that sleep is an integral component of CVH. In our study, even a CVH score that includes only sleep duration, the most widely measured aspect of sleep health and the most feasible measure to obtain in a clinic or public health setting, predicted CVD incidence,” said Makarem in the Columbia news release. 

“Notably, we also found that a CVH score that incorporated multiple dimensions of sleep health was also significantly associated with incident CVD,” she said.

“Our results highlight the importance of embracing a holistic vision of sleep health that includes sleep behaviors and highly prevalent, mild sleep problems — rather than strictly focusing on sleep disorders when assessing an individual’s cardiovascular risk.”

Individuals who slept fewer hours had higher chances of having low sleep efficiency (defined as less than 85% time in bed after lights off spent sleeping), the news release explained about the study’s findings. 

Also, those with less sleep duration were likely to have irregular sleep patterns — meaning variations in sleep duration and timing — across days. 

They were also likely to experience excessive daytime sleepiness and sleep apnea, the release said. 

Findings also revealed a higher prevalence of Type 2 diabetes, hypertension and obesity/overweight in those considered “short duration sleepers.” 

This suggested that multiple unhealthy sleep dimensions may occur simultaneously and interact — which could further increase the risk for heart disease, the release said. 

Sixty-three percent of participants slept less than 7 hours per night and 30% slept less than 6 hours, the study found. 

It also found that 39% had high night-to-night variability in sleep duration and 25% had a high variation in sleep timing. 

The study also found that 14% reported excessive daytime sleepiness and 36% stated they had high insomnia symptoms. 

In addition, the study found 47% of the people who participated had moderate-to-severe sleep apnea (OSA).

“The most important advice when it comes to promoting sleep health is to make sleep a priority,” said Makarem to Fox News Digital. 

“Sleep seems to be the first thing that people squeeze out of their schedules when they are busy. However, the first step to healthy sleep is making time for sleep to ensure that you get 7-8 hours of sleep each night, the ideal sleep duration for promoting heart health.”

‘Better sleep hygiene’

It’s important to practice good sleep hygiene, which means putting yourself in the best position to sleep well by optimizing your sleep schedule, bedtime routine and sleep environment, the lead author told Fox News Digital.

There are a few ways to get better sleep habits, she said.

“Stick to a stable sleep schedule, meaning try to go to bed and wake up at the same time every day, and try to keep the same sleep schedule on weekdays and weekends to avoid disrupting your body clock’s sleep-wake rhythm,” she said.

“Use the hour before bedtime to relax and unwind, and optimize your sleep environment by making your bedroom comfortable, quiet, cool and dark.”

Makarem also suggested getting rid of distractions such as bright light and noise.

“Avoid sources of bright light such as computers, TVs and phones before bedtime. Also, try to drown out any noise by using earplugs or a white noise machine, and avoid stimulants such as nicotine and caffeine,” she told Fox News Digital.   

Fox News medical contributor Dr. Marc Siegel, weighing in on the study, said that sleep is a time for the heart and brain to repair. 

“When you are sleeping, hormones are released, including oxytocin, that are cardio-protective and promote heart healing,” he told Fox News Digital. 

“When you are awake, especially when you are anxious, stress hormones are released, which increase heart rate blood pressure and overall stress on the heart.”

Dr. Siegel added, “Sleep is a rejuvenating time for the heart and brain.”

Dr. Deepak L. Bhatt, MD, MPH, director of Mount Sinai Heart and a Dr. Valentin Fuster Professor of Cardiovascular Medicine at the Icahn School of Medicine at Mount Sinai Health System in New York City, told Fox News Digital, “This is a very informative study that shows an association between insufficient sleep duration (defined here as less than 7 hours or more than 9 hours) and worse cardiovascular health.” 

He said as well, “People who slept less than the recommended amount were also found to have higher rates of obesity, diabetes and high blood pressure, which are well-established risk factors for heart disease as well.”

Bhatt was not part of the study but was a senior author on the American Heart Association scientific statement on sleep and cardio metabolic risk.

He also said, “Insufficient sleep doesn’t get the respect it deserves as a cardiovascular risk factor.” He added that he hopes “studies such as this one will change societal attitudes about the importance of a good night’s sleep.”

The team of Columbia University researchers said in the release that they recommend additional research be conducted regarding the relationship of sleep to lifetime risk of developing CVD.  

The team also said that clinical trials are needed to evaluate the impact of screening for sleep problems and improving the different dimensions of sleep health through sleep hygiene interventions on cardiovascular outcomes.