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The connection between insufficient sleep quality and heightened cardiovascular risk has already been extensively documented. Nonetheless, many studies focus on singular aspects of sleep, such as sleep duration or sleep apnea, exploring only one facet of sleep at a specific moment.
A team from Inserm, France’s National Institute of Health and Medical Research, has presented findings from a more comprehensive study on how sleep impacts cardiovascular risk. This study assesses five sleep patterns influencing sleep quality: sleep duration, insomnia, chronotype (“eveningness” or “morningness”), sleep apnea, and daytime drowsiness. Participants completed a questionnaire based on these patterns, assigning each individual a sleep score ranging from 0 (disturbed sleep) to 5 (ideal sleep). Ideal sleep is characterized by 7-8 hours of nightly sleep, early rising and bedtime, absence of insomnia, sleep apnea, and daytime drowsiness.
Reducing Cardiovascular Risk The questionnaire was administered to two cohorts involved in population surveys. Sleep scores were calculated at enrollment and two years later for one study, and five years later for the other. A subset of participants also underwent polysomnography testing. The study aimed to evaluate the overall impact of the five sleep patterns on cardiovascular risk and how they change over time. The study encompassed over 11,000 individuals aged 53-64 years (44.6% women), with cardiovascular follow-up spanning eight to ten years.
The data analysis revealed three key observations. First, a higher initial sleep score correlated with a lower cardiovascular risk, with an 18% risk reduction for each additional point in the initial sleep score (hazard ratio [HR], 0.82). Second, the risk decreased by 16% for each additional score point between the two evaluations (HR, 0.84). Finally, the authors estimated that achieving the maximum level for at least four sleep characteristics could prevent 30% to 60% of new cardiovascular incidents.
Room for Enhancement It’s noteworthy that two-thirds of participants scored high (three or above) on the initial assessment, and this score remained stable over follow-ups. About 8% improved their score, while 11% saw it drop below three. Additionally, for some participants (17.2%), the score remained stable but below three. The authors suggest future research should focus on these last two groups to identify potentially modifiable factors to reverse these trends.
The correlation between good sleep quality and reduced cardiovascular disease risk is more robust for those with a good initial score, underscoring the importance of achieving and maintaining good sleep quality early in life. Nevertheless, the reduced risk associated with an improvement in score over time in people with an initially low score suggests it’s never too late to enhance sleep quality. The authors advocate for early public awareness of the importance of sleep quality and quantity, as well as screening and treating sleep disorders promptly. They propose that cognitive-behavioral therapy is effective for treating insomnia, and various therapies exist for sleep apnea based on its phenotype and severity. While chronotype is influenced by genetics, behavioral measures and chronotherapy can be employed for those with misaligned biological clocks. Healthcare professionals’ training is also identified as a potential avenue for solutions.
This study could pave the way for promoting healthy sleep practices and fostering collaboration between sleep and cardiovascular medicine.
