The European Society of Cardiology has warned that elderly people, who regularly report feeling sleepy during the day, may face an increased risk of dying from cardiovascular disease.
The warning comes following the publication of a French study by the American Heart Association in the journal Stroke.
The Three City study found that elderly people who reported excessive day time sleepiness have a 49 per cent relative risk increase of cardiovascular death from cerebrovascular disease, myocardial infarction, and heart failure as compared to those who did not report sleepiness.
"Based on this study asking patients the simple question of whether they feel sleepy during the day, is a useful way of identifying a subgroup of elderly patients at higher risk of cardiovascular disease who require a more thorough follow up," said Professor Guy DeBacker, from the Division of Cardiology at the University of Gent, Belgium, and former chair of the European Society of Cardiology Joint Prevention Committee.
Professor Torben Jorgensen, from the Research Centre for Prevention and Health, Glostrup, Denmark, said: "The study offers the opportunity to practice prevention by investigating the underlying causes of patient's sleep problems, and then introducing lifestyle changes with the intention of preventing later cardiovascular complications."
The Three City study represents the largest yet investigation exploring the prospective association between "excessive" day time sleepiness (EDS) and mortality in the community dwelling elderly, and the only study yet to have been conducted in Europe - all the other studies were undertaken in North America.
The researchers, however, admit that the data needs to be confirmed in other large-scale studies in different populations before any changes should be made to existing guidelines.
"Overall the study population had a particularly low number of cardiovascular deaths, suggesting that the French paradox may be in operation. We need to be asking identical questions to different populations to see if we still get the same effect," said DeBacker.
The researchers also say that they have yet to determine whether sleep complaints are a symptom of underlying cardiovascular disease, or whether sleepiness triggers or worsens disease.
"These data may have clinical implications adding to the body evidence that EDS is not a benign but rather an important risk marker for midterm mortality in community dwelling elderly," they conclude, adding that simple questionnaires incorporating questions on sleeping patterns should become part of routine examinations in the elderly.
Jorgensen says that he will like to see future trials where EDS patients are randomised to receive sleep interventions or not, to see whether cardiovascular complications may be prevented.