Increased mortality linked with poor sleep in patients with heart disease or stroke

By Melanie Hinze
Short sleep duration increases mortality risk in middle-aged adults with cardiometabolic risk factors and in those with cardiac or cerebrovascular disease, according to US research published in the Journal of the American Heart Association.

Researchers assessed whether objective short sleep duration increased the risk of mortality associated with cardiometabolic risk factors (hypertension and/or type 2 diabetes) and cardiac and cerebrovascular diseases (heart disease and/or stroke) in 1654 adults, mean age 47.5 years, from the Penn State Adult Cohort. After 19.2 years, 512 patients were deceased: 209 died from cardiac or cerebrovascular diseases and 131 from cancer. In participants who slept less than six hours a night, those with cardiometabolic risk factors had a 1.83 increased risk of cardiac and cerebrovascular disease mortality whereas those with cardiac and cerebrovascular diseases had a 2.92 increased risk of death from cancer.

Commenting, Associate Professor Alan Young, President of the Australasian Sleep Association and Director of Sleep Services at Eastern Health, said the study showed that sleep duration modified the effect of these cardiac risk factors, resulting in worse outcomes than each on their own.

He said this was a well designed, important study that added to the evidence linking sleep with cardiovascular disease, cancer risk and mortality, noting also that it was a large cohort with an impressive follow up of 19 years.

A strength was that sleep duration was measured objectively using in-laboratory sleep study rather than self-reports. Additionally, the authors controlled for a range of covariants including sex, age, race, smoking, obesity, obstructive sleep apnoea (OSA) and other physical and mental health conditions.

‘What this means for GPs is that they can ask people about their sleep while assessing the established cardiac risk factors,’ he said. ‘When patients have short sleep duration, they can then look at what can be done to improve sleep and also to rule out sleep disorders, particularly OSA.’
J Am Heart Assoc 2019; 8: e013043; doi: 10.1161/JAHA.119.013043.