The duration of our sleep could significantly impact our heart health. A recent study, detailed in the Journal of the American College of Cardiology (fn. 1) looked at the link between sleep duration and myocardial malfunction (MI), commonly known as a heart attack. The study was conducted on an extensive scale with over 460,000 participants. Understanding this connection is especially vital given the alarming prevalence and death rates associated with heart attacks in the United States. And it has special urgency for those who have a family history of heart problems.
American Heart Association 2023 Heart Disease and Stroke Statistics
The American Heart Association's most recent statistics regarding heart disease and stroke include the following (fn. 2):
Cardiovascular Disease (CVD) is listed as the underlying cause of 928,741 deaths in the United States in 2020. CVD accounted for approximately 19.05 million global deaths in 2020.
Heart disease and stroke claim more lives each year in the United States than all forms of cancer and Chronic Lower Respiratory Disease (CLRD) combined.
CVD death can take on many forms. In 2020 in the United States, coronary heart disease (CHD) was the leading cause (41.2%) of CVD deaths, followed by stroke (17.3%), other CVD (16.8%), high blood pressure (12.9%), heart failure (9.2%), and disease of the arteries (2.6%).
Non-Hispanic Black females and males had the highest prevalence of CVD in the US. From 2017 to 2020 in the United States, 59% of non-Hispanic Black females and 58.9% of non-Hispanic black males had some form of CVD.
CVD accounted for 12% of total US health expenditures in 2018 to 2019. That is more than any major diagnostic group.
SLEEP AND MYOCARDIAL INFARCTION
The Sleep Categories: Short, Long, and the Goldilocks Zone
The study categorized sleep into three groups: short sleep (less than 6 hours), long sleep (more than 9 hours), and the Goldilocks zone, representing the optimal 6 to 9 hours of nightly sleep. The findings were striking, revealing a significant association between sleep duration and the incidence of heart attacks.
Short Sleepers: 20% Higher Risk
Individuals classified as short sleepers, getting less than 6 hours of sleep per night, faced a 20% higher risk of experiencing a heart attack compared to those who achieved the recommended 6 to 9 hours of sleep. In the United States alone, where heart disease remains the leading cause of death, this statistic underscores the urgency of addressing sleep habits for overall cardiovascular health.
Long Sleepers: 34% Higher Risk
Surprisingly, long sleepers, those clocking in more than 9 hours of sleep each night, also showed a 34% higher risk of myocardial infarction. While the reasons behind this association are not fully understood, it highlights the complexity of the relationship between sleep and cardiovascular health. As heart disease continues to contribute significantly to the mortality rate in the U.S., understanding these nuances becomes crucial.
Beyond Sleep Duration: Unpacking the Complexity
The study did not stop at sleep duration alone. It considered other sleep traits and genetic predisposition to coronary artery disease. Even when accounting for these factors, the link between sleep duration and heart health remained significant. Moreover, individuals with a genetic inclination to coronary diseases saw their risk mitigated by maintaining a healthy sleep duration.
Mendelian Randomization: Unveiling Causality
To ascertain causality, the researchers employed Mendelian randomization (MR), a sophisticated technique using genetic variants as proxies for modifiable risk factors. The MR analysis consistently pointed to a causal relationship between short sleep duration and an increased risk of myocardial infarction.
How a Lack of Sleep Can Affect Your Heart Health
The Study does not hypothesize why the Goldilocks Zone is better for your heart health. By the Center For Disease Control notes that there are a number of factors that play a role in heart disease that could be improved by regular Good Sleep. (fn. 3)
Blood pressure may play a role. "During normal sleep, your blood pressure goes down. Having sleep problems means your blood pressure stays higher for a longer period of time.4 High blood pressure is one of the leading risks for heart disease and stroke. About 75 million Americans—1 in 3 adults—have high blood pressure."
Blood sugar levels, and diabetes, may also be affected by a lack of sleep. "Diabetes is a disease that causes sugar to build up in your blood, a condition that can damage your blood vessels. Some studies show that getting enough good sleep may help people improve blood sugar control."
Obesity may also be affected by sleep--both too much sleep and not enough sleep. Getting insufficient sleep may affect that part of the brain that controls hunger. And getting too much sleep may result in a person burning less energy than necessary to maintain healthy weight. Unhealthy weight gain is one of the major factors in heart disease.
It's also not clear if the study isolated for sleep apnea. Sleep apnea, in addition to reducing the amount of quality sleep one gets, also harms the heart by not getting enough oxygen into the body.
Conclusion: A Wake Up Call to Prioritize Sleep
In a nation grappling with the pervasive impact of heart disease, this study serves as a wake-up call. Prioritizing the Goldilocks zone of sleep duration—6 to 9 hours—emerges not just as a lifestyle choice but a crucial element in safeguarding heart health. The findings advocate for a holistic approach to well-being, where good sleep is not merely a luxury but a necessity.
If you won't do it for yourself, do it for those who love you.
Mahalo Mucho,
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FOOTNOTES:
Sleep Duration and Myocardial Infarction, Journal of the American College of Cardiology, Volume 74, Issue 10, 2019, Pages 1304-1314. ISSN 0735-1097. https://doi.org/10.1016/j.jacc.2019.07.022
Heart disease and stroke statistics—2023 update: a report from the American Heart Association [published ahead of print January 25, 2023]. https://professional.heart.org/-/media/PHD-Files-2/Science-News/2/2023-Heart-and-Stroke-Stat-Update/2023-Statistics-At-A-Glance-final_1_17_23.pdf
Center for Disease Control and Prevention, About High Blood Pressure, How Does Sleep Affect Your Heart Health? https://www.cdc.gov/bloodpressure/sleep.htm
KE:YWORDS
Sleep duration and cardiovascular health
Myocardial infarction risk factors
Mendelian randomization analysis
Cardiovascular risk profile
Sleep disorders and public health
Sleep and genetic predisposition to diseases
Preventive cardiology and sleep interventions
Heart attack
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