A good night's sleep increases the cardiovascular benefits of a healthy lifestyle

July 2, 2013, European Society of Cardiology

A good night's sleep can increase the benefit of exercise, healthy diet, moderate alcohol consumption and non-smoking in their protection against cardiovascular disease (CVD), according to results of a large population follow-up study.(1) Results showed that the combination of the four traditional healthy lifestyle habits was associated with a 57% lower risk of cardiovascular disease (fatal and non-fatal) and a 67% lower risk of fatal events. But, when "sufficient sleep" (defined as seven or more hours a night) was added to the other four lifestyle factors, the overall protective benefit was even further increased - and resulted in a 65% lower risk of composite CVD and a 83% lower risk of fatal events.

"If all participants adhered to all five healthy lifestyle factors, 36% of composite CVD and 57% of fatal CVD could theoretically be prevented or postponed," the authors report. "The public health impact of sufficient sleep duration, in addition to the traditional healthy lifestyle factors, could be substantial."

The study is published today in the European Journal of Preventive Cardiology, and is the first to investigate whether the addition of sleep duration to the four traditional healthy lifestyle factors contributes to an association with CVD.

The Monitoring Project on Risk Factors for Chronic Diseases (MORGEN) is a in the Netherlands from which 6672 men and 7967 women aged 20 years and free of CVD at baseline were followed up for a mean time of 12 years. Details of physical activity, diet, alcohol consumption, smoking and sleep duration were recorded between 1993 and 1997, and the subjects followed-up through a cross-link to national hospital and mortality registers.

As expected, results showed that adherence to each of the four traditional lifestyle factors alone reduced the risk of CVD. Those at baseline who recorded sufficient , a healthy diet and reduced their risk of composite CVD from 12% for a to 43% for not smoking; and risk reduction in fatal CVD ranged from 26% for being physically active to 43% for not smoking.

However, sufficient sleep duration alone also reduced the risk of composite CVD by about 22% (HR 0.78) and of fatal CVD by about 43% (HR 0.57) when compared with those having insufficient sleep. Thus, non-smoking and sufficient sleep duration were both strongly and similarly inversely associated with fatal CVD.

These benefits were even greater when all five lifestyle factors were observed, resulting in a in a 65% lower risk of composite CVD and an 83% lower risk of fatal CVD.

As background to the study, the investigators note that poor sleep duration has been proposed as an independent risk factor for CVD in two other (non-European) studies, but without adding the effect of sleep to other healthy lifestyle benefits. This study - in a large population - now suggests that sufficient sleep and to all four traditional factors are associated with a lower CVD risk. When sufficient sleep duration is added to the traditional , the risk of CVD is even further reduced.

As an explanation for the results, the investigators note that short sleep duration has been associated with a higher incidence of overweight, obesity and hypertension and with higher levels of blood pressure, total cholesterol, haemoglobin A, and triglycerides, effects which are "consistent with the hypothesis that short sleep duration is directly associated with CVD risk".

The study's principal investigator, Dr Monique Verschuren from the National Institute for Public Health and the Environment in the Netherlands, said that the importance of sufficient sleep "should now be mentioned as an additional way to reduce the ". "It is always important to confirm results," she added, "but the evidence is certainly growing that sleep should be added to our list of CVD ."

Dr Verschuren noted that seven hours is the average sleeping time that "is likely to be sufficient for most people". An earlier study from her group in the Netherlands, which included information on sleep quality, found that those who slept less than seven hours and got up each morning not fully rested had a 63% higher risk of CVD than those sleeping sufficiently - although those who woke rested, even from less than seven hours' sleep, did not have the increased risk.(2)

Explore further: Do insomnia and disrupted sleep during menopause increase a woman's risk of heart disease?

More information: 1. Hoevenaar-Blom M, Spijkerman AMW, Kromhout D, Verschuren WMM. Sufficient sleep duration contributes to lower cardiovascular disease risk in addition to four traditional lifestyle factors: the MORGEN study. Eur J Prevent Cardiol 2013; DOI: 10.1177/2047487313493057

2. Hoevenaar-Blom MP, Spijkerman AM, Kromhout D, et al. Sleep duration and sleep quality in relation to 12-year cardiovascular disease incidence: the MORGEN study. Sleep 2011; 34: 1487-92.

Related Stories

Do insomnia and disrupted sleep during menopause increase a woman's risk of heart disease?

May 9, 2013
Insomnia and other sleep disturbances are common among perimenopausal and postmenopausal women and may increase their risk of coronary heart disease (CHD) and cardiovascular disease (CVD). Evidence that a combination of altered ...

Depression, antidepressant use linked to future CVD risk

June 10, 2013
(HealthDay)—For patients with type 2 diabetes, higher self-reported depression symptoms and antidepressant medicine (ADM) use in the previous year are independently associated with developing certain cardiovascular disease ...

Snoring tied to increased cardiovascular risk in women

February 14, 2013
(HealthDay)—For women, snoring is associated with a modest increased risk of stroke, coronary heart disease (CHD), and cardiovascular disease (CVD), according to a study published in the Feb. 15 issue of The American Journal ...

Survived cancer? Now look out for cardiovascular risks

April 16, 2013
Many people survive their cancers, but end up dying of cardiovascular disease (CVD). New research from Wake Forest Baptist Medical Center finds that CVD risk factors may be overlooked during survivorship care.

Increasing severity of erectile dysfunction is a marker for increasing risk of cardiovascular disease and death

January 29, 2013
A large study published in PLOS Medicine on January 29, 2013, shows that the risk of future cardiovascular disease and death increased with severity of erectile dysfunction in men both with and without a history of cardiovascular ...

Healthy living adds 14 years to your life

November 5, 2012
If you have optimal heart health in middle age, you may live up to 14 years longer, free of cardiovascular disease, than your peers who have two or more cardiovascular disease (CVD) risk factors, according to a new Northwestern ...

Recommended for you

Researchers borrow from AIDS playbook to tackle rheumatic heart disease

January 22, 2018
Billions of US taxpayer dollars have been invested in Africa over the past 15 years to improve care for millions suffering from the HIV/AIDS epidemic; yet health systems on the continent continue to struggle. What if the ...

A nanoparticle inhalant for treating heart disease

January 18, 2018
A team of researchers from Italy and Germany has developed a nanoparticle inhalant for treating people suffering from heart disease. In their paper published in the journal Science Translational Medicine, the group describes ...

Starting periods before age of 12 linked to heightened risk of heart disease and stroke

January 15, 2018
Starting periods early—before the age of 12—is linked to a heightened risk of heart disease and stroke in later life, suggests an analysis of data from the UK Biobank study, published online in the journal Heart.

'Decorated' stem cells could offer targeted heart repair

January 10, 2018
Although cardiac stem cell therapy is a promising treatment for heart attack patients, directing the cells to the site of an injury - and getting them to stay there - remains challenging. In a new pilot study using an animal ...

Two simple tests could help to pinpoint cause of stroke

January 10, 2018
Detecting the cause of the deadliest form of stroke could be improved by a simple blood test added alongside a routine brain scan, research suggests.

Exercise is good for the heart, high blood pressure is bad—researchers find out why

January 10, 2018
When the heart is put under stress during exercise, it is considered healthy. Yet stress due to high blood pressure is bad for the heart. Why? And is this always the case? Researchers of the German Centre for Cardiovascular ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.