Sleep may be as important to heart health as diet and physical activity, research suggests

(CNN) — If you want to keep your heart healthy, add a good night’s rest to your to-do list, says a new study.

Heart disease is the nation’s No. 1 killer, according to the US Centers for Disease Control and Prevention. Someone in the United States dies of cardiovascular disease every 34 seconds.

In June, the American Heart Association added sleep duration to its cardiovascular health checklist, now called “Life’s Essential 8.” These science-based guidelines are designed to help all Americans improve their heart health.

The eight elements: Quit smoking, eat better, be active, manage weight, manage blood pressure, control cholesterol, lower blood sugar and get sound sleep.

Some of the research behind the change was published Wednesday in the Journal of the American Heart Association.

Research by scientists at Columbia University’s Mailman School of Public Health shows that cardiovascular health guidelines are more effective at predicting a person’s heart disease risk if they include sleep.

Researchers looked at the sleep records of 2,000 middle-aged or older people in an ongoing US study of cardiovascular disease and cardiovascular risk factors, called the Multi-Ethnic Study of Atherosclerosis, or MESA.

Participants took part in a detailed sleep study. They filled out sleep surveys, wore a device that measured their sleep for seven days, and did an overnight study in which scientists could observe how they slept.

Poor sleep habits “are ubiquitous” among Americans, the study said, including among survey participants. About 63% of them sleep less than seven hours a night, and 30% sleep less than six hours. The optimal amount of sleep for an adult is between seven and nine hours a night, according to the CDC.

People who sleep less than seven hours a night have a greater chance of “low sleep efficiency,” irregular sleep patterns, excessive daytime sleepiness, and sleep apnea. Specifically, almost half of the people in the study had moderate to severe sleep apnea. More than a third reported symptoms of insomnia, and 14% reported excessive daytime sleepiness.

Those who slept less than seven hours had a higher prevalence of heart disease risk factors such as obesity, type 2 diabetes and high blood pressure. Other studies have also shown links between short sleep and chronic diseases, which can also harm heart health.

“Poor sleep is also associated with other poor health behaviors,” said study author Nur Makarem, an assistant professor of epidemiology at the Mailman School of Public Health. These unhealthy behaviors also contribute to poor heart health.

There is growing evidence that people who don’t get enough sleep often have a poor diet, Makarem said. This may be partly because sleep is a restorative process that, among other things, produces and regulates hormones that can make you feel full or hungry. When these hormones go out of whack, you may need to eat more and look for calorie-dense foods that give you energy quickly.

Poor sleep is also associated with lower physical activity, Makarem said.

“Both poor diet and lack of exercise are, of course, also important risk factors for heart disease,” she said. “So sleep is associated with many risk factors for cardiovascular disease, including psychological risk factors.”

Poor sleep can increase stress levels and the risks of depression, both of which affect heart health.

“In summary, sleep is associated with clinical or psychological and lifestyle risk factors for heart disease. So it’s no surprise that poor sleep would increase the future risk of heart disease,” Makarem added.

Sharon Cobb, director of prelicensure nursing programs and associate professor at the Mervyn M. Dymally School of Nursing at Charles R. Drew University of Medicine and Science in Los Angeles, said it’s important for health care providers to consider sleep. when assessing someone’s overall health.

She hopes future studies will provide further evidence of the link between good health and good sleep and prompt more providers to ask questions.

“They measure your blood pressure, they ask you how well you eat and how much you exercise, but not many ask, ‘how well do you sleep at night?'” said Cobb, who was not involved in the new research. “Good sleep is essential for promoting good health.”

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