Middle aged women who have ongoing insomnia or get little sleep each night may be at greater risk for heart disease, according to new research presented at The North American Menopause Society Conference in Philadelphia in Sept.
Heart disease is the leading killer of women in the United States, and once women hit menopause, their risk of developing it increases. Researchers wanted to examine whether issues with sleep—a chief complaint among menopausal women—could be behind the uptick in cardiovascular risk.
How the study was done
A research team at the University of Pittsburgh School of Public Health assessed data from SWAN, a long-term study of 3,300 mid-life women from five different racial and ethnic groups across the U.S.
The team asked participants whether they’d had trouble falling asleep, woke up during the night, or woke up earlier than planned in the prior month—classic insomnia symptoms. Women were considered to have insomnia if they reported any of these issues three or four times per week. Participants were also classified into short sleep duration (5 hours), moderate duration (6 hours) or long duration (7 hours) sleepers.
Researchers further assessed cardiovascular disease events, including heart attack, stroke, bypass surgery, heart failure and heart disease-related death.
Sleep and heart disease risk
“Women with persistent insomnia had a significantly elevated risk of cardiovascular disease compared with women who had few insomnia symptoms over midlife,” said Rebecca Thurston, professor of psychiatry and director of the Women's Biobehavioral Health Laboratory, University of Pittsburgh School of Public Health.
There was an almost doubling of risk between the two groups, Thurston said, and even when age, race, ethnicity, education, and other cardiovascular disease risk factors were accounted for, the increased risk was still significant, at 1.7 times.
When just sleep duration data was analyzed, women with persistent short sleep had marginally increased cardiovascular disease risk vs. moderate, or longer sleepers, however, overall data showed that women with both persistent insomnia and short sleep were at highest risk of heart disease.
“Midlife women with persistent insomnia symptoms either alone or in combination with short sleep duration had a 70% to 75% increased risk of cardiovascular disease events over the two decades of follow up, after adjusting for demographic factors and cardiovascular disease risk factors,” Thurston said. “These findings underscore the importance of considering sleep when we're assessing women's cardiovascular disease risks.”
Sleep is critical for middle aged women
Midlife is a time directly before the onset of clinical cardiovascular disease events in women. “It's a critical time for cardiovascular disease prevention,” Thurston said. She encouraged mid-life women and their physicians to discuss sleep patterns and start making any necessary behavioral changes that could help reduce heart disease risk.
The American Heart Association has previously noted a link between the menopausal transition and heart disease. Their Life’s Essential 8 program can help you minimize your risks:
- Eat nutritious foods: Choose whole foods, plenty of fruits and vegetables, lean protein, nuts, seeds, and use non-tropical oils such as olive and canola.
- Stay active: Adults should get 2 ½ hours of moderate or 75 minutes of vigorous physical activity per week.
- Quit tobacco: Use of cigarettes, e-cigarettes and vaping, is the leading cause of preventable death in the U.S., including about a third of all deaths from heart disease.
- Get quality sleep: Most adults need 7 to 9 hours per night. Adequate sleep promotes healing, improves brain function and reduces the risk for chronic diseases.
- Manage weight: Achieving and maintaining a healthy weight has many benefits. AHA recommends using body mass index as a guide but the American Medical Association recently adopted a new policy regarding BMI as “an imperfect way” to measure body fat in multiple groups since it doesn’t account for race/ethnicity, sex, gender, and age-span.
- Control cholesterol: High levels of non-HDL, or “bad,” cholesterol can lead to heart disease. AHA suggests discussing monitoring of non-HDL cholesterol as the preferred number to monitor, rather than total cholesterol, because it can be measured without fasting beforehand and is reliably calculated among all people.
- Manage blood sugar: High levels of blood sugar can damage your heart, kidneys, eyes and nerves.
- Manage blood pressure: Keeping your blood pressure within acceptable ranges can keep you healthier longer. Levels less than 120/80 mm Hg are optimal. High blood pressure is defined as 130-139 mm Hg.
