Too little sleep may raise death risk in people with cluster of heart disease risk factors

May 24, 2017

DALLAS, May 24, 2017 -- People with a common cluster of risk factors for heart disease and diabetes were approximately twice as likely to die of heart disease or stroke as people without the same set of risk factors if they failed to get more than six hours of sleep, according to a new observational study published in the association's open access publication Journal of the American Heart Association. For those who got more sleep, the risk of death was more modest.

The study, funded in part by the American Heart Association, is the first to measure sleep duration in the laboratory rather than rely on patient reports and the first to examine the impact of sleep duration on the risk of death in those with a common cluster of heart disease risk factors.

The researchers randomly selected 1,344 adults (average age 49 years, 42 percent male) who agreed to spend one night in a sleep laboratory as part of the Penn State Adult Cohort. Based on their test results, 39.2 percent of the participants were found to have at least three of the risk factors, that when clustered together are known as the metabolic syndrome. For this study, the cluster included body mass index (BMI) higher than 30 and elevated total cholesterol, blood pressure, fasting blood sugar and triglyceride levels.

During an average follow-up of 16.6 years, 22 percent of the participants died.

Compared to people without the same cluster of risk factors, those with metabolic syndrome who clocked more than six hours of sleep time in the lab were about 1.49 times more likely to die of stroke during the 16.6-year follow-up period, while those who slept less than six hours in the lab were about 2.1 times more likely to die of heart disease or stroke. The short sleepers with metabolic syndrome were also 1.99 times more likely to die from any cause compared to those without metabolic syndrome.

The relationship was particularly striking because the researchers adjusted for sleep apnea - sleep interrupted by pauses in breathing that is a known heart disease risk.

"If you have several heart disease risk factors, taking care of your sleep and consulting with a clinician if you have insufficient sleep is important if you want to lower your risk of death from heart disease or stroke," said study lead author Julio Fernandez-Mendoza, Ph.D., an assistant professor at Penn State College of Medicine and sleep psychologist at the Sleep Research & Treatment Center of the Penn State Health Milton S. Hershey Medical Center in Hershey, Pennsylvania.

He noted that sleep lab studies are often used to rule out sleep apnea, but physicians should also note insufficient sleep in the lab because it may signal a higher risk of death in patients with risk factors for heart disease.

A recent scientific statement from the American Heart Association on sleep duration and quality noted that an increasing number of Americans suffer from sleep difficulties or choose to curtail sleep in favor of other social, leisure, or work-related activities and this may be associated with adverse cardiovascular risks and outcomes.

As the Fernandez-Mendoza research was an observational study, the results cannot establish a cause-and-effect, only an association between short sleep and mortality in people with the metabolic syndrome. Additional limitations include that the study used only one day of sleep lab results and enrolled too few minority patients to determine whether there are racial differences in the relationship between short sleep times and mortality.

"Future clinical trials are needed to determine whether lengthening sleep, in combination with lowering blood pressure and glucose, improves the prognosis of people with the metabolic syndrome" said Fernandez-Mendoza.
-end-
Co-authors are Fan He, M.S.; Caitlin LaGrotte, Psy.D.; Alexandros N. Vgontzas, M.D.; Duanping Liao, M.D., Ph.D.; and Edward O. Bixler, Ph.D.

Author disclosures are on the manuscript. The American Heart Association and the National Heart, Lung, and Blood Institute funded the study.

Additional Resources: Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association's policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at http://www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke - the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation's oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

American Heart Association

Related Heart Disease Articles from Brightsurf:

Cellular pathway of genetic heart disease similar to neurodegenerative disease
Research on a genetic heart disease has uncovered a new and unexpected mechanism for heart failure.

Mechanism linking gum disease to heart disease, other inflammatory conditions discovered
The link between periodontal (gum) disease and other inflammatory conditions such as heart disease and diabetes has long been established, but the mechanism behind that association has, until now, remained a mystery.

New 'atlas' of human heart cells first step toward precision treatments for heart disease
Scientists have for the first time documented all of the different cell types and genes expressed in the healthy human heart, in research published in the journal Nature.

With a heavy heart: How men and women develop heart disease differently
A new study by researchers from McGill University has uncovered that minerals causing aortic heart valve blockage in men and women are different, a discovery that could change how heart disease is diagnosed and treated.

Heart-healthy diets are naturally low in dietary cholesterol and can help to reduce the risk of heart disease and stroke
Eating a heart-healthy dietary pattern rich in vegetables, fruits, whole grains, low-fat dairy products, poultry, fish, legumes, vegetable oils and nuts, which is also limits salt, red and processed meats, refined-carbohydrates and added sugars, is relatively low in dietary cholesterol and supports healthy levels of artery-clogging LDL cholesterol.

Pacemakers can improve heart function in patients with chemotherapy-induced heart disease
Research has shown that treating chemotherapy-induced cardiomyopathy with commercially available cardiac resynchronization therapy (CRT) delivered through a surgically implanted defibrillator or pacemaker can significantly improve patient outcomes.

Arsenic in drinking water may change heart structure raising risk of heart disease
Drinking water that is contaminated with arsenic may lead to thickening of the heart's main pumping chamber in young adults, according to a new study by researchers at Columbia University Mailman School of Public Health.

New health calculator can help predict heart disease risk, estimate heart age
A new online health calculator can help people determine their risk of heart disease, as well as their heart age, accounting for sociodemographic factors such as ethnicity, sense of belonging and education, as well as health status and lifestyle behaviors.

Wide variation in rate of death between VA hospitals for patients with heart disease, heart failure
Death rates for veterans with ischemic heart disease and chronic heart failure varied widely across the Veterans Affairs (VA) health care system from 2010 to 2014, which could suggest differences in the quality of cardiovascular health care provided by VA medical centers.

Heart failure: The Alzheimer's disease of the heart?
Similar to how protein clumps build up in the brain in people with some neurodegenerative diseases such as Alzheimer's and Parkinson's diseases, protein clumps appear to accumulate in the diseased hearts of mice and people with heart failure, according to a team led by Johns Hopkins University researchers.

Read More: Heart Disease News and Heart Disease Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.