Heart Disease and Sleep: Expert Panel Reports That Both Duration and Quality May Impact Heart Health

In its first scientific statement on sleep, the American Heart Association and its committee of heart health and sleep researchers, including Michael Grandner, PhD, of the UA College of Medicine – Tucson, find in a review of current evidence that too much or too little sleep, along with sleep-related breathing irregularities and insomnia, may be linked to heart risk factors.

Sleep duration including too little or too much sleep and sleep disorders, may be linked to a variety of factors that may raise the risk for cardiovascular diseases, according to the first ever American Heart Association (AHS) scientific statement published this week in the AHA journal Circulation.

A committee of experts in heart health and sleep science, including statement co-author Michael Grandner, PhD, MTR, assistant professor of psychiatry, psychology and medicine at the University of Arizona, reviewed all existing evidence in the scientific literature on the impact of sleep duration and sleep disorders to cardiovascular health and risk and noted the following:

  • Sleeping too little or too long, along with sleep disorders such as sleep apnea and insomnia, may be linked to cardiovascular risk factors including obesity, hypertension, type 2 diabetes and cardiovascular disease.
  • Research linking sleep problems to obesity and diabetes is robust, but longer studies measuring impact on actual weight are needed.
  • Simple sleep behavior screening tools should be developed and evaluated for use in clinical care and public health settings.
  • Treating those with sleep disorders may provide clinical benefits, particularly for blood pressure.
  • Research studies should include more diverse populations (i.e., minorities, women, and overweight and obese participants.)

The AHA did not have a recommendation on how much sleep is needed for cardiovascular wellness citing lack of more specific scientific evidence. More and better evidence is needed to directly link inadequate or poor sleep to diabetes, high blood pressure and cardiovascular disease, the statement said.

Much of the scientific research about sleep and heart health focuses on insomnia or sleep apnea. Insomnia is defined as difficulty falling or staying asleep, for at least three nights a week for three or more months. Sleep apnea is diagnosed when someone has an average of five or more pauses in breathing, which can last seconds to minutes, per hour of sleep; the pauses are most commonly due to a narrowed airway.

“Our findings in this groundbreaking statement make it clear there is a lot of work yet to be done to understand the complex relationship between a heathy heart and sleep. But we do know that healthy sleep is necessary for good health, and sleep is an important factor in cardiovascular health, obesity, diabetes and psychological well-being,” said Dr. Grandner, a UA Sarver Heart Center member. He also is director of the Sleep and Health Research Program in the UA Department of Psychiatry and director of the Behavioral Sleep Medicine Clinic at Banner – University Medical Center Tucson (for appointments, call 520-626-6255).

Dr. Grandner specializes in non-medication treatments for patients with sleep disorders such as insomnia in his behavioral sleep clinical practice. His research focus is on how sleep and sleep-related behaviors are related to cardiovascular disease, diabetes, obesity, neurocognitive functioning, mental health and longevity.  

“We know the heart-health benefits of exercise and a diet rich in plant-based foods. To be able to add a sleep recommendation to our tool kit is something we whole-heartedly welcome,” said Nancy K. Sweitzer, MD, PHD, director of the UA Sarver Heart Center and chief of cardiology at the UA College of Medicine – Tucson.   

In addition to expertise in cardiology at Sarver and the sleep programs Dr. Grander directs, the University of Arizona Health Sciences has a dedicated team of interdisciplinary sleep researchers and sleep labs, including the Center for Sleep Disorders at the UA College of Medicine – Tucson and Banner – University Medical Center Tucson, and the Social, Cognitive and Affective Neuroscience (SCAN) Lab at the UA Department of Psychiatry.

Marie-Pierre St-Onge, PhD, associate professor at Columbia University and research associate at New York Obesity Research Center, chaired the AHA panel. Additional co-authors include Devin Brown, MD, MS, professor, University of Michigan; Molly B. Conroy, MD, MPH, associate professor, University of Pittsburgh; Girardin Jean-Louis, PhD, professor, NYU School of Medicine; Michael Coons, PhD, CBSM, assistant professor, University of Toronto; and Deepak L. Bhatt, MD, MPH, professor, Harvard Medical School.

Evidence linking sleep problems to obesity and diabetes has been studied the most, said St-Onge. “Those are the two main conditions in which there are intervention studies that show that risk factors are increased when sleep is altered.”

Obesity studies show sleep influences food intake and could directly impact obesity risk, but the research has been for short periods and longer studies — measuring impact on actual weight — are needed. Longer studies could help show whether sleep variations over the course of weeks impact patients’ blood cholesterol, triglycerides, or inflammatory markers, said St-Onge.

The AHA scientific statement, “Sleep Duration and Quality: Impact on Lifestyle Behaviors and Cardiometabolic Health: A Scientific Statement From the American Health Association,” was published on Sept. 19.

About the UA Sarver Heart Center

The UA Sarver Heart Center’s 143 members include faculty from cardiology, cardiothoracic surgery, pediatric cardiology, neurology, vascular surgery, radiology, endocrinology, emergency medicine, nursing, pharmacy and basic sciences. The UA Sarver Heart Center emphasizes a highly collaborative research environment, bridging “bench and bedside” research that advances life-saving innovations and patient care. If you would like to give permission for Sarver Heart Center to contact you about heart research studies, please complete a Cardiology Research Registry Information Form.

About the University of Arizona Health Sciences

The University of Arizona Health Sciences is the statewide leader in biomedical research and health professions training. The UA Health Sciences includes the UA Colleges of Medicine (Phoenix and Tucson), Nursing, Pharmacy and Mel and Enid Zuckerman College of Public Health, with main campus locations in Tucson and the growing Phoenix Biomedical Campus in downtown Phoenix. From these vantage points, the UA Health Sciences reaches across the state of Arizona and the greater Southwest to provide cutting-edge health education, research, patient care and community outreach services. A major economic engine, the UA Health Sciences employs almost 5,000 people, has nearly 1,000 faculty members and garners more than $126 million in research grants and contracts annually. For more information: http://uahs.arizona.edu