Sleep Should Be Another Measure of Heart Health

The preliminary findings, presented Thursday at the American Heart Association’s Epidemiology and Prevention/Lifestyle and Cardiometabolic Health Scientific Sessions in Phoenix, recommend changing the AHA’s Life’s Simple 7 measure of cardiovascular health to the “Simple 8 or Essential 8” to incorporate sleep metrics.

“Sleep, like diet and physical activity, is a health behavior we engage in every day,” said lead author Nour Makarem, an associate research scientist at Columbia University Irving Medical Center in New York. “Increasingly, it is linked to not only the risk of heart disease but also to the risk factors that lead to cardiovascular disease. Despite this importance, unlike diet and exercise, sleep has received less attention and is not currently included in guidelines for cardiovascular disease prevention or as a measure of cardiovascular health.”

About 4 in 10 people report consistently getting a good night’s sleep and more than 50 million Americans experience some type of sleep disorder. An AHA scientific statement in 2016 said insufficient and poor-quality sleep, along with sleep disorders, are linked to a higher risk for heart disease as well as to several major heart disease risk factors, such as obesity, Type 2 diabetes and high blood pressure.

The Life’s Simple 7 tool, created in 2010 to measure a person’s cardiovascular health, includes metrics on tobacco use, diet, physical activity, body mass index, blood pressure, total cholesterol and blood sugar levels.

In the new study, researchers looked at how adding combinations of different sleep metrics to this tool would impact cardiovascular health scores for 1,920 ethnically diverse middle-aged and older adults, a population considered at high risk for developing heart disease. They then compared their heart health scores, with and without sleep metrics, to see which was the stronger predictive tool.

“Even if you just add sleep duration as an eighth metric of heart health, the new heart health score would be more strongly associated with cardiovascular disease risk than the traditional Life’s Simple 7,” Makarem said.

For example, participants who got seven to eight hours of sleep a night in addition to meeting Life’s Simple 7 guidelines had up to 61% lower odds of having heart disease.

Her team also investigated adding different sleep characteristics, including sleep duration; insomnia; excessive daytime sleepiness; sleep apnea; sleep efficiency (how much time in bed is spent sleeping); and sleep variability (inconsistent sleep schedules).