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Duration and Quality of Sleep Crucial for Cardiovascular Health

Duration and Quality of Sleep Crucial for Cardiovascular Health

Written by Dr. Kaushik Bharati, MSc, PhD, FRSPH (London)
Article Reviewed by 
The Medindia Medical Review Team on January 17, 2019 at 5:09 PM
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  • Duration and quality of sleep are crucial for maintaining optimal cardiovascular health
  • People who sleep less than 6 hours at night are more likely to develop atherosclerosis than those who sleep 7-8 hours, without fragmentation of sleep
  • This can prevent the development of cardiovascular disease

Good quality and adequate amount of sleep are very important for optimal cardiovascular health, a new study suggests. People who sleep between 7 to 8 hours at night are at a far lesser risk of cardiovascular disease (CVD) than those who sleep for less than 6 hours.

The new PESA CNIC-Santander Study indicates that poor quality sleep increases the risk of atherosclerosis, which causes plaque build-up on the inner walls of the arteries throughout the body. This can significantly elevate the risk of CVD. The study was jointly led by Dr. Valentin Fuster, MD, PhD, and José M. Ordovás, PhD.

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Duration and Quality of Sleep Crucial for Cardiovascular Health

Dr. Fuster is the currently the General Director at the National Center for Cardiovascular Research or Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain. He is also a Professor of Medicine and Cardiology at Mount Sinai and Director, Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai, New York, USA. He is also the Editor-in-Chief of JACC.

Dr. Ordovás is a Senior Scientist and Director of the Nutrition and Genomics Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Massachusetts, USA.

The study has been published in the Journal of the American College of Cardiology (JACC).

Study Background

The study is based on the premise that cardiovascular health could be maintained by factors other than conventional preventive strategies such as a healthy diet, daily physical activity, and medications. One of these factors is sleep and its role in preventing CVD. In this regard, Ordovás said: "There are two things we usually do every day: eat and sleep. We've known for many years the relation between good nutrition and cardiovascular health; however, we don't know as much the relation between sleep and cardiovascular health." Therefore, it follows that the role of sleep should be evaluated as one of the interventions to fight CVD.

What Were the Drawbacks of Previous Studies?

Previous studies suffered from the following drawbacks:
  • Studies included patients with health problems such as sleep apnea, which can cause bias
  • Studies relied solely on questionnaires for obtaining information on sleep, which is not as accurate as direct measurements
  • Studies stressed that lack of sleep increased CVD risk through indirect risk factors like blood pressure, blood glucose, inflammation, and obesity
  • Direct risk factors like atherosclerosis were not studied

What's New in the Current Study?

Some of the unique features of the new study include the following:
  • Study was much larger, which included almost 4,000 participants
  • Study focused on a healthy population
  • Study used actigraphs to gather objective data on sleep. An actigraph is a small device worn on the wrist that continuously measures activity or movement
  • First study to show that objectively measured sleep is independently linked to atherosclerosis throughout the body and not just in the heart

Study Procedure

The study population was divided into the following four groups based on sleep duration:
  • Sleep duration: < 6 hours
  • Sleep duration: 6-7 hours
  • Sleep duration: 7-8 hours
  • Sleep duration: > 8 hours
Other features of the study procedure include the following:
  • The study included 3,974 participants with an average age of 46 years
  • None of the participants suffered from heart disease
  • Two-thirds of the population were males
  • Prevalence and progression of subclinical cardiac lesions were detected by 3D cardiac ultrasound and cardiac computed tomography (CT) scanning
  • Sleep patterns of the participants were recorded for 7 days by an actigraph

Study Findings

The following major study findings were noted:
  • There was a 27 percent more likelihood of developing atherosclerosis in those who slept < 6 hours at night than those who slept for 7-8 hours
  • There was a 34 percent more likelihood of developing atherosclerosis in those who had poor quality sleep than those who had good quality sleep. Quality of sleep depends on the frequency of waking up at night and frequency of movements during sleep
  • Sleep duration > 8 hours increases the risk of atherosclerosis, especially in women

Concluding Remarks

The impact of sleep duration and quality of sleep in atherosclerosis was evaluated. This revealed that participants who slept less than 6 hours per night or experienced a fragmented sleep pattern, had more cholesterol plaques compared to those who slept longer without any interruption. Therefore, this study indicates that sleep duration and quality are of vital importance in cardiovascular health.

In this regard, Fuster concludes: "Medicine is entering into a fascinating phase. Until now we have tried to understand the cardiovascular disease. But thanks to studies like PESA CNIC- Santander, we are starting to understand health."

Funding Source

The study was funded by a public-private-partnership (PPP) between the Spanish Government (through the Carlos III Institute of Health) and the Pro CNIC Foundation, which includes 13 Spanish private companies.

Reference :
  1. Association of Sleep Duration and Quality with Subclinical Atherosclerosis - (http://www.onlinejacc.org/content/73/2/134)

Source: Medindia

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