Nav: Home

Poor sleep may increase risk for irregular heart rhythms

November 14, 2016

NEW ORLEANS, Nov. 14, 2016 -- Disruptions in sleep may be raising your risks of an irregular heartbeat, known as atrial fibrillation (AF), according to preliminary research presented at the American Heart Association's Scientific Sessions 2016.

Obstructive sleep apnea, sleep interrupted by pauses in breathing, is a known risk for atrial fibrillation - an irregular heartbeat that can lead to strokes, heart failure and other heart-related complications. But whether there's a relationship between disrupted sleep and atrial fibrillation even when there's no sleep apnea is unclear.

Presentation 733: Researchers at the University of California, San Francisco examined three sources of data - each using a different approach - to isolate and confirm the effects of poor sleep on atrial fibrillation. Their analyses of these studies showed that:
  • disrupted sleep, including insomnia, may be independently associated with atrial fibrillation;

  • people who reported frequent night-time awakening had about a 26 percent higher risk of developing atrial fibrillation compared to those who didn't wake up a lot; and

  • people diagnosed with insomnia had a 29 percent higher risk of developing atrial fibrillation compared to those without insomnia.

Insomnia meant having trouble falling asleep, not getting enough sleep, or having poor sleep.

"The idea that these three studies gave us consistent results was exciting," said lead study author Matt Christensen, currently a fourth-year medical student at the University of Michigan in Ann Arbor.

Past research has shown a link between poor sleep among people who already had AF. But this study focused on people whose pre-existing sleep disruptions were associated with developing AF later in life.

The data sources included the Health eHeart Study - an internet-based cross-sectional study of more than 4,600 people; the Cardiovascular Health Study - an 11-year longitudinal study of just over 5,700 people, of which almost 1,600 (28 percent) developed atrial fibrillation; and the California Healthcare Cost and Utilization Project, a hospital-based database spanning five years and covering almost 14 million patients.

In all three studies, researchers adjusted for the effects of obstructive sleep apnea and AF risk factors that might also be related to sleep. Some of those factors were age, sex, race, diabetes, high blood pressure, heart failure and smoking.

Diving deeper into sleep patterns and AF

Poster 218: In a separate analysis, the same researchers reviewed a subset of the Cardiovascular Health Study to understand the effect of sleep disruptions during different sleep phases without obstructive sleep apnea on atrial fibrillation risks.

The analysis showed that having less rapid-eye movement (REM) sleep than other sleep phases during the night is linked to higher chances of developing atrial fibrillation.

"By examining the actual characteristics of sleep, such as how much REM sleep you get, it points us toward a more plausible mechanism. There could be something particular about how sleep impacts the autonomic nervous system," Christensen said. The autonomic nervous system plays a major role in controlling heart rate and blood pressure.

Another possible explanation for the link between sleep disruptions and atrial fibrillation is that frequent waking puts extra stress on the heart's chambers, said Christensen. Participants in this analysis were also enrolled in the Sleep Heart Health Study. They had a formal sleep study to objectively measure sleep quality. That's another element which strengthened the study's conclusions, said Christensen, as it didn't rely on self-reported data.

In this analysis, 1,131 people (average age 77) participated in a study with almost 10 years of follow-up.

Researchers measured how long participants slept, how well they slept, how long it took to fall asleep and the patterns of sleep (i.e., how much time was spent in rapid-eye movement (REM) sleep versus non-REM sleep). Then they analyzed the sleep disruptions' effects to control the effects of age, sex, race, smoking, diabetes, high blood pressure, and other risk factors.

Study authors say the exact link between sleep and how AF develops is still a mystery, but we are getting closer to a clear picture.

"Ultimately, even without a clear understanding of the responsible mechanisms, we believe these findings suggest that strategies to enhance sleep quality, such as incorporating known techniques to improve sleep hygiene, may help prevent this important arrhythmia," said senior author of both abstracts Gregory Marcus, M.D., M.A.S., a cardiologist at the University of California, San Francisco.

Poor sleep is a known culprit for other heart disease risk factors such as high blood pressure, obesity and stroke. So it's important to know how to get a good night's rest.

Getting enough physical activity, avoiding too much caffeine, and having an evening routine are good starting tips for sound slumber. Talk to your doctor if you're having trouble with poor sleep.
-end-
Co-authors are Matthew Christensen, B.S.; Shalini Dixit, M.D.; Thomas Dewland, M.D.; Isaac Whitman, M.D.; Gregory Nah, M.A.; Eric Vittinghoff, Ph.D.; Kenneth Mukamal, M.D., M.P.H.; Susan Redline, M.D., M.P.H.; John Robbins, M.D., M.H.S.; Anne Newman, M.D., M.P.H.; Sanjay Patel, M.D.; Jared Magnani, M.D.; Bruce Psaty, M.D., Ph.D.; Jeffrey Olgin, M.D.; Mark Pletcher, M.D., M.P.H.; and Susan Heckbert, M.D., Ph.D. Author disclosures are on the abstract.

This study is funded in part by the Sarnoff Cardiovascular Research Foundation, the National Institutes of Health and the Agency for Healthcare Research and Quality.

Note: Scientific Presentation 733 is 10:50 a.m. CT, Nov. 15, in the Science and Technology Hall. Scientific Presentation 218 is 11:30 a.m. CT, Nov. 14, in Room 338-339.

Additional Resources: Statements and conclusions of study authors that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position. The association makes no representation or warranty 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 are available at http://www.heart.org/corporatefunding.

American Heart Association

Related Heart Failure Articles:

Type 2 diabetes may affect heart structure and increase complications and death among heart failure patients of Asian ethnicity
The combination of heart failure and Type 2 diabetes can lead to structural changes in the heart, poorer quality of life and increased risk of death, according to a multi-country study in Asia.
Preventive drug therapy may increase right-sided heart failure risk in patients who receive heart devices
Patients treated preemptively with drugs to reduce the risk of right-sided heart failure after heart device implantation may experience the opposite effect and develop heart failure and post-operative bleeding more often than patients not receiving the drugs.
How the enzyme lipoxygenase drives heart failure after heart attacks
Heart failure after a heart attack is a global epidemic leading to heart failure pathology.
Novel heart pump shows superior outcomes in advanced heart failure
Severely ill patients with advanced heart failure who received a novel heart pump -- the HeartMate 3 left ventricular assist device (LVAD) -- suffered significantly fewer strokes, pump-related blood clots and bleeding episodes after two years, compared with similar patients who received an older, more established pump, according to research presented at the American College of Cardiology's 68th Annual Scientific Session.
NSAID impairs immune response in heart failure, worsens heart and kidney damage
Non-steroidal anti-inflammatory drugs, or NSAIDs, are widely known as pain-killers and can relieve pain and inflammation.
Heart cell defect identified as possible cause of heart failure in pregnancy
A new Tel Aviv University study reveals that one of the possible primary causes of heart failure in pregnant women is a functional heart cell defect.
In heart failure, a stronger heart could spell worse symptoms
Patients with stronger-pumping hearts have as many physical and cognitive impairments as those with weaker hearts, suggesting the need for better treatment.
Patients with common heart failure more likely to have lethal heart rhythms
New Smidt Heart Institute Research shows that patients with Heart Failure with Preserved Ejection Fraction (HFpEF) are more likely to have lethal heart rhythms.
Why does diabetes cause heart failure?
A Loyola University Chicago Stritch School of Medicine study reveals how, on a cellular level, diabetes can cause heart failure.
Oxygen therapy for patients suffering from a heart attack does not prevent heart failure
Oxygen therapy does not prevent the development of heart failure.
More Heart Failure News and Heart Failure Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Rethinking Anger
Anger is universal and complex: it can be quiet, festering, justified, vengeful, and destructive. This hour, TED speakers explore the many sides of anger, why we need it, and who's allowed to feel it. Guests include psychologists Ryan Martin and Russell Kolts, writer Soraya Chemaly, former talk radio host Lisa Fritsch, and business professor Dan Moshavi.
Now Playing: Science for the People

#538 Nobels and Astrophysics
This week we start with this year's physics Nobel Prize awarded to Jim Peebles, Michel Mayor, and Didier Queloz and finish with a discussion of the Nobel Prizes as a way to award and highlight important science. Are they still relevant? When science breakthroughs are built on the backs of hundreds -- and sometimes thousands -- of people's hard work, how do you pick just three to highlight? Join host Rachelle Saunders and astrophysicist, author, and science communicator Ethan Siegel for their chat about astrophysics and Nobel Prizes.