Cardiovascular health: Insomnia linked to greater risk of heart attack

  • Insomnia involves having trouble falling asleep or staying asleep.
  • Data from a recent review found that insomnia and getting only five hours of sleep or less at night are associated with an increased risk for heart attack.
  • Regardless of specifics, people can take steps to get a good night’s sleep and improve insomnia.

As research progresses, experts are finding more and more reasons for people to prioritize sleep. One area of interest is how the sleep disorder insomnia increases the risk for other health problems.

A​ recent review published in Clinical Cardiology examined how insomnia increases the risk of a heart attack. The review found that people with insomnia were 69% more likely to experience heart attacks. Researchers suggest that insomnia should be addressed as an essential heart attack risk factor.

How insomnia and sleep affect health

Insomnia happens when people have trouble falling asleep or staying asleep. Chronic insomnia occurs when the problem lasts for three months or more. Several factors can increase someone’s risk for insomnia, such as high-stress levels or chronic pain.

W​hen people don’t get enough sleep, it can lead contribute to a variety of unpleasant symptoms and increase the risk for specific health problems. Non-study author Dr. Harneet Walia, director of Sleep Medicine and Continuous Improvement at Baptist Health Miami Cardiac & Vascular Institute, explained to Medical News Today:

“Insomnia is associated with impairment in quality of life ranging from fatigue, sleepiness, mood changes, increased absenteeism, and low attention. They may also have decreased cognitive function. There are studies to suggest that insomnia is associated with cardiovascular and metabolic risk such as high blood pressure, heart attack and diabetes.”

N​on-study author Dr. Wafi Momin, a cardiologist with UTHealth Houston Heart & Vascular and Memorial Hermann, further noted the following reasons for a good night’s sleep:

“Sleep is vital in helping the body repair itself. Getting at least 7 hours of sleep each night helps your body recover and allows you to function normally the following day. Regular, consistent sleep also helps regulate blood pressure, sugar levels, as well as weight. These health problems are linked to heart disease such as heart attack and stroke, so getting plenty of sleep and regulating these risk factors can be of much help.”

Insomnia and cardiovascular risk

This particular systematic review and meta-analysis looked at the association between insomnia and the incidence of heart attack, also called myocardial infarction (MI). It included controlled observational studies about heart attacks in people eighteen or older.

Researchers included nine studies in their analysis and research, including 153,881 people with insomnia and 1,030,375 people who did not have insomnia. Studies came from six different countries, allowing for diversity in data collection.

T​he results of the study found that people with insomnia were at a significantly higher risk for heart attack than people who did not have insomnia. People with insomnia were 69% more likely to experience a heart attack.

In addition, getting five or fewer hours of sleep at night was associated with a much higher risk for heart attack than getting between seven and eight hours of sleep. People who got five or fewer hours of sleep each night were 56% more likely to experience a heart attack than those who got between seven and eight hours of sleep at night.

Study author Dr. Hani Aiash, Ph.D. noted the key findings of the research to MNT:

“Our results have shown that insomnia increases the risk of MI by 69%, subsequently, patients should be educated about the importance of sleep, and sleep should be incorporated into primary cardiovascular prevention guidelines.”

Researchers found that the risk for heart attack was higher among females with insomnia. However, the risk association was still present across key subgroups based on sex, co-comorbidities, and age. The results indicate that insomnia is a serious risk factor that all adults should take seriously.

Researchers concluded that people should treat insomnia as another risk factor for heart attack. With this in mind, people can take steps to treat insomnia and thus lower their heart attack risk.

Study limitations and continued research

T​his particular review did have certain limitations. First, there was significant variation between the studies that researchers included in their review. For example, there was variation between sample sizes and study length.

Second, most of the studies relied on data from questionnaires, which can increase the risk of bias and errors. Researchers only included papers written in English, which limits the study’s findings.

​Dr. Aiash, Ph.D. noted the following areas for continued research:

“I believe we should investigate the relationship between the duration of insomnia and the subsequent risk of MI. (Will being an insomniac for long durations result in higher risk? What is the minimum duration of disease i.e., insomnia that results in an increased risk of MI?).”

“Additionally, 96% of our patient population didn’t have prior attacks of MI and the other 4% were accounted for. Would prior heart attacks result in a higher risk of recurrence among insomniacs compared to insomniacs who didn’t suffer from heart attacks before?”

Taking steps for a better night’s sleep

The study highlights the importance of managing insomnia. D​r. Aiash, Ph.D., noted that it’s crucial to take insomnia seriously. He explained that people should “Consider insomnia as a modifiable risk factor for MI. [It] must be treated as Diabetes or Hypertension to decrease the incidence of MI. It is important that clinicians educate the patients about the importance of sleep in maintaining a healthy heart and encourage proper sleep hygiene.”

To manage insomnia, doctors may encourage people to modify certain lifestyle habits, like restricting electronics before bed or limiting caffeine intake to certain times of the day. These changes can be used in conjunction with cognitive behavioral therapy and relaxation techniques.

D​r. Walia noted a few key steps in sleep hygiene:

  • maintain a regular sleep and wake schedule every day, including the weekends.
  • avoid electronics in the evening
  • avoid caffeine later in the day
  • avoid taking long naps late in the day
  • maintain a conducive sleep environment
  • physical activity and exercise during the day promote sleep

S​he further added that “if someone continues to struggle with insomnia, they should seek medical attention, as there may be other sleep or medical or psychiatric disorders leading to insomnia.”

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