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Lack of sleep increases heart attack and stroke risk

A bad night’s sleep raises the risk of potentially fatal heart attacks and strokes, research has found. And experts warn that women are at higher risk because they are more prone to insomnia, reports the Daily Express.

A large-scale study of over 160,000 people found a clear association between sleep problems and the debilitating effects of a heart attack or stroke.

Difficulty getting off to sleep, staying asleep, and waking up not feeling refreshed increased the risks by 27%, 11%, and 18% respectively. Women are at a slightly higher risk than men as they are more prone to insomnia because of differences in genetics, sex hormones and their reaction to stress.

The report says sleep is vital as a restorative time and plays a significant role in healing and repairing the heart and blood vessels. It also gives the immune system and the cardiovascular system a rest and allows other organs to be restored. The study looked at the connection between insomnia symptoms and incidents or death from cardiovascular disease, including acute myocardial infarction, coronary heart disease and heart failure, or stroke, or a combination of issues.

Researchers examined 15 studies with a total of 160,867 participants.

The report says the study found women with insomnia symptoms had a slightly higher risk of cardiovascular and stroke events than men, especially for non-restorative sleep. However, the difference between sexes did not reach statistical significance.

Researcher Qiao He from China Medical University said: “Sleep is important for biological recovery and takes around a third of our lifetime, but in modern society more and more people complain of insomnia.

Researchers have found associations between insomnia and poor health outcomes. “But the links between insomnia and heart disease or stroke have been inconsistent.” He added: “The underlying mechanisms for these links are not completely understood.

“Previous studies have shown that insomnia may change metabolism and endocrine function, increase sympathetic activation, raise blood pressure, and elevate levels of pro-inflammatory and inflammatory cytokines – all of which are risk factors for cardiovascular disease and stroke.

“We cannot conclude that insomnia is more dangerous for women.

“However, we do know that women are more prone to insomnia because of differences in genetics, sex hormones, stress, and reaction to stress.

“It may therefore be prudent to pay more attention to women’s sleep health.”

She concluded: “Sleep disorders are common in the general population and sleep health should be included in clinical risk assessment.

“Health education is needed to increase public awareness of insomnia symptoms and the potential risks, so that people with sleep problems are encouraged to seek help.”

Commenting on the research, Dr Mike Knapton, associate medical director at the British Heart Foundation, said: “Problems sleeping is a common complaint that people take to their GP and this study confirms that difficulty getting off to sleep, or poor quality sleep are associated with a small increased risk of heart disease.

“However other factors such as smoking, high cholesterol and high blood pressure contribute significantly more to your overall risk of a heart attack or stroke than sleep problems do.

“Whilst this study appears to show that sleep problems increase your risk of heart disease the relationship between cause and effect is not known. We have funded a research project led by Professor Andrew Steptoe at University College London to answer this question.”

A spokesperson from The Sleep Council said: “This shows people must prioritise sleep as its as important as exercise and diet. Chronic poor sleep can increase risks of stroke as this study shows. The old adage ‘if you snooze you lose’ is out of date and harmful for health. People should have a sleep routine with regular bed-time and waking times and make sure they get as much fresh air and natural daylight as possible.”

The report says separate research has found that a sleep disorder might be as bad for triggering a heart attack or stroke as smoking or failing to exercise. People who get less than seven hours are up to four times more likely to suffer a stroke and double their risk of a heart attack.

Professor Valery Gafarov, of the World Health Organisation, said: “Sleep is not a trivial issue.”

Abstract
Background: Insomnia symptoms have been suggested to be associated with the risk of cardio-cerebral events. However, the results of previous studies have been inconsistent. Therefore, we conducted a meta-analysis to examine whether there were associations between cardio-cerebral vascular events and insomnia symptoms, including difficulty initiating sleep, difficulty maintaining sleep, early-morning awakening or non-restorative sleep.
Design: A meta-analysis of prospective cohort studies.
Methods: PubMed, Web of science and the Cochrane Library were searched without language restriction. Prospective cohort studies of adults with at least a 2-year follow-up duration were included. Random effect models were used in order to pool the results for each insomnia symptom. Subgroup and sensitivity analyses were conducted in order to assess potential heterogeneity, and funnel plots and Egger’s tests were used in order to assess publication bias.
Results: Fifteen studies (23 cohorts) were included. Positive associations were observed between difficulty initiating sleep, difficulty maintaining sleep and non-restorative sleep with risk of cardio-cerebral vascular events. The pooled relative risks and 95% confidence intervals were 1.27 (1.15–1.40), 1.11 (1.04–1.19) and 1.18 (1.05–1.33), respectively. However, less evidence existed to support the conclusions about the association between early-morning awakening and cardio-cerebral vascular events.
Conclusion: Our meta-analysis demonstrated that insomnia symptoms of difficulty initiating sleep, difficulty maintaining sleep and non-restorative sleep were associated with an increased risk of future cardio-cerebral vascular events.

Authors
Qiao He, Peng Zhang, Guangxiao Li, Huixu Dai, Jingpu Shi

[link url="http://www.express.co.uk/life-style/health/786494/poor-sleep-increase-shock-study-increase-risk-fatal-heart-attack-strokes"]Daily Express report[/link]
[link url="http://journals.sagepub.com/doi/full/10.1177/2047487317702043"]European Journal of Preventative Cardiology abstract[/link]

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