Unhealthy sleeping pattern is linked to an increased risk of cardiovascular disease (CVD). People with poor sleep may have a decreased life expectancy attributed to CVD; thus, poor sleep constitutes a significant public health burden! A recently published population-based prospective cohort study has reported a loss of approximately 2 years in CVD-free life expectancy (an estimate of how many years a person would live without CVD until death, at a given age) among participants with poor sleep compared to healthy sleepers. Similar influence of sleep disturbances/abnormal sleeping patterns was observed on CVD-free life expectancy of participants with clinically diagnosed sleep disorders (sleep-related breathing disorders, insomnia, and other sleep disorders).
This prospective cohort study collected self-reported data of middle-aged adult participants (n = 3,08,623; median age = 56.2 years) on sleep disturbances from the UK Biobank database.Available inpatient or primary care data for nearly half of the participants (n = 1,40,181) on clinically confirmed sleep disorder events (diagnosed within 2 years before study enrollment) was also retrieved.
Poor sleep was defined as the absence of four or more healthy sleep characteristics [7 to <9 hours of sleep duration, absence of insomnia, snoring, or frequent daytime sleepiness, and morning chronotypes] whereas healthy sleep was defined as the presence of four or more healthy sleep characteristics. The healthy sleep characteristics and sleep disorders were determined at baseline from self-reported and inpatient records, respectively. Count of healthy sleep characteristics (composite sleep score) was used to group the participants into the following groups – i) Healthy sleepers (composite score ≥4); ii) Intermediate sleepers (composite score 2–3); and iii) Poor sleepers (composite score ≤1). At 40 years of age, CVD-free life expectancy of the participants with self-reported sleep profiles and clinically confirmed sleep disorders were analyzed using three-state Cox Markov survival models.
Cardiovascular disease-free life expectancy was 30.03 and 33.05 years in males and females, respectively. Self-reported poor sleepers showed a greater likelihood of development of CVD and reported a greater loss in average number of CVD-free years compared to intermediate and healthy sleepers (Graphic A). Among clinically diagnosed sleep disorders, sleep-related breathing disorders accounted for largest loss of CVD-free life years in both the sexes compared to other conditions (Graphic B).
Clinical Implications
The findings of this study suggest that improving quality of sleep may help in alleviating the negative impact of poor sleep on CVD-free life expectancy. Sleep-related breathing disorders accounted for the maximum loss in CVD-free years in both males and females; thus, a timely diagnosis and management of this condition will help deter its hazardous effect on cardiac health.
(Reference: Huang BH, Del Pozo Cruz B, Teixeira-Pinto A, Cistulli PA, Stamatakis E. Influence of poor sleep on cardiovascular disease-free life expectancy: A multi-resource-based population cohort study. BMC Med. 2023;21(1):75. Doi: 10.1186/s12916-023-02732-x)