Healthy sleep habits can stave off heart failure

Adults with healthy sleep habits saw their risk of heart failure (HF) reduced by almost half compared with those who have unhealthy sleep patterns, according to data from the UK Biobank.

“Sleep behaviours are intercorrelated, and the human body regulates sleep in a holistic way to maintain an overall constancy of sleep intensity, quality, and duration,” said the researchers.

The observational study included 408,802 participants aged 37 to 73 years from the prospective UK Biobank cohort.  Participants self-reported on five categories of sleep behaviours: whether they rose in the morning, slept for 7–8 hours a day, had no snoring, no frequent insomnia, and no excessive daytime sleepiness. [Circulation 2020;doi:10.1161/CIRCULATIONAHA.120.050792]

“The healthy sleep score we created was based on the scoring of these five sleep behaviours,” explained principal investigator Professor Qi Lu, director of the Obesity Research Center, Tulane University in New Orleans, Louisiana, US. Each of the sleep behaviour was scored 1 for healthy pattern and 0 vice versa.

Participants with the healthiest sleep habits (sleep score of 5) had 42 percent lower risk of HF (adjusted hazard ratio [HR], 0.58; p<0.001) compared with the reference group with unhealthy sleep patterns (sleep score of 0–1).

For each one-point increment in the sleep score, the risk of HF dropped by 15 percent (adjusted hazard ratio [HR], 0.85; p<0.001), after controlling for age, sex, ethnicity, alcohol intake, physical activity, smoking status, diet, income, education level. This association remained even after further adjusting for diabetes, hypertension, and genetic variations (HR, 0.87; p<0.001).

“Our results provide new evidence to indicate that adherence to the healthy sleep pattern is associated with a lower risk of HF, independent of the conventional risk factors,” pointed out Qi and co-authors.

“[Also,] our study extends the previous findings on individual sleep behaviours by jointly evaluating multiple sleep behaviours,” they noted.

When each sleep behaviour was analysed independently, the researchers found that HF risk was significantly lower by 8 percent in early risers (p=0.04), by 12 percent in participants with 7–8 hours of sleep daily (p=0.002), by 17 percent in those without frequent insomnia (p<0.001), and by 34 percent in those without daytime sleepiness (p<0.001) — compared with the reference group.

“Our findings highlight the importance of improving overall sleep patterns to help prevent HF,” said Qi.

Due to the observational nature of the study, the researchers acknowledged that there may be unmeasured residual confounders, which may limit the findings. Also, no causal relationship can be inferred from the analysis. As sleep habits were self-reported, the data might be subjected to recall bias.