AHA releases statement on the link between sleep disorders, cardiovascular health

Sleep disorders such as obstructive sleep apnea and insomnia are associated with adverse cardiometabolic risk profiles and outcomes, according to an American Heart Association (AHA) scientific statement.

The AHA also found that sleep restriction negatively impacted energy balance and treating people with sleep disorders could provide clinical benefits.

The statement was published online in Circulation Sept. 19. To gather their data, the authors searched the Ovid Medline, Embase, Cochrane and clinicaltrials.gov databases in February 2015 and identified research published in 2005 or later.

“We know that short sleep, usually defined as under seven hours per night, overly long sleep, usually defined as more than nine hours per night, and sleep disorders may increase some cardiovascular risk factors, but we don’t know if improving sleep quality reduces those risk factors,” Marie-Pierre St-Onge, PhD, the panel’s chairperson and an associate professor of nutritional medicine at Columbia University, said in a news release. “Since the scientific evidence doesn’t show a specific dose/response relationship between sleep duration and cardiovascular wellness, the [AHA] cannot offer specific advice on how much sleep is needed to protect people from cardiovascular disease.”

Approximately 50 million to 70 million U.S. adults suffer from a sleep disorder or report insufficient sleep each year, according to data from the National Heart, Lung and Blood Institute. The authors added that 5 percent to 15 percent of adults have insomnia, while 27 percent to 34 percent of men and 9 percent to 28 percent of women between 30 and 70 years old have sleep apnea.

The authors mentioned that the American Academy of Sleep Medicine and the Sleep Research Society recommend at least seven hours of sleep per night for adults. However, fewer people have been getting that much sleep in recent years.

They cited a study that found 29.1 percent of U.S. adults in 2009 slept less than seven hours per night, down from 31.6 percent in 1977. Meanwhile, 7.8 percent of U.S. adults in 2009 slept more than nine hours per night, down from 11.6 percent in 1977.

The authors suggested that the AHA address sleep behavior though a public health campaign that includes guidelines for adequate sleep and how to screen for sleep duration and sleep disorders in routine clinical care and public health settings. They also said existing tools to screen for sleep apnea should be better integrated into clinical care and public health settings.

Future studies should include more diverse populations, have longer-term follow-up periods and use accurate and objective measures of sleep behavior, according to the researchers. They also recommended developing and evaluating simple sleep behavior screening tools and brief intervention strategies and testing the impact of other sleep disorders such as restless leg syndrome and periodic limb movement on cardiometabolic risk.

St-Onge noted that intervention studies have found that altered sleep patterns could lead to an increased risk for obesity and diabetes. However, the authors said that longer-term studies are needed to show whether sleep variations affect blood cholesterol, triglycerides or inflammatory markers and more evidence is needed to link inadequate or poor sleep to diabetes, high blood pressure and cardiovascular disease.

“Patients need to be aware that adequate sleep is important, just as being physically active and eating a balanced diet rich in fruits, vegetables, whole grains, lean meat and fish are important for cardiovascular health,” St-Onge said. “Sleep is another type of ammunition that we can tailor to improve health.”