STUDY USING THE AMERICAN HEART ASSOCIATION FRAMEWORK PROVIDES EVIDENCE THAT SLEEP IS INTEGRAL TO PRESERVING HEART HEALTH

Researchers at Columbia University Mailman School of Public Health evaluated an expanded measure of cardiovascular health (CVH) that includes sleep as an eighth metric, in relation to cardiovascular disease risk. This represents the first examination of adding sleep to the American Heart Association’s original Life’s Simple 7 (LS7) metrics as a novel eighth metric of CVH. The study is published in the Journal of the American Heart Association.
 
The study sample consisted of ~2000 middle-aged to older adults from the Multi-Ethnic Study of Atherosclerosis (MESA), an ongoing U.S. study of CVD and CVD risk factors, who participated in a sleep exam and provided comprehensive data on their sleep characteristics.
 
The research evaluated multiple expanded cardiovascular health scores –including the American Heart Association’s Life’s Simple 7 (LS7) metrics — plus different sleep health measures, to evaluate which sleep parameters should be prioritized for CVD prevention.  This study is the first to show that sleep metrics add independent predictive value for CVD events over and above the original 7 CVH metrics.

Importantly, cardiovascular health scores that included sleep duration only as a measure of overall sleep health as well as cardiovascular health scores that included multiple dimensions of sleep health (i.e. sleep duration, efficiency, and regularity, daytime sleepiness, and sleep disorders) were both predictive of future CVD. For the sleep duration metric, sleeping 7 hours or more but less than 9 hours each night was considered indicative of ideal sleep health.
 
“Our results demonstrate that sleep is an integral component of CVH. In our study, even a CVH score that includes only sleep duration, the most widely measured aspect of sleep health and the most feasible measure to obtain in a clinic or public health setting, predicted CVD incidence,” said Nour Makarem, PhD, assistant professor of epidemiology at Columbia Mailman School of Public Health and lead author of the study. “Notably, we also found that a CVH score that incorporated multiple dimensions of sleep health was also significantly associated with incident CVD. Our results highlight the importance of embracing a holistic vision of sleep health that includes sleep behaviors and highly prevalent, mild sleep problems rather than strictly focusing on sleep disorders when assessing an individual’s cardiovascular risk.”
 
Overall, the study found that 63 percent of participants slept less than 7 hours per night and 30 percent slept less than 6 hours, while 39 percent and 25 percent had high night-to-night variability in sleep duration and sleep timing, respectively; 14 percent and 36 percent reported having excessive daytime sleepiness and high insomnia symptoms, respectively; and 47 percent had moderate-to-severe sleep apnea (OSA), where breathing repeatedly stops and starts.

According to Nour Makarem and colleagues, the finding that a sleep health score based solely on sleep duration as well as a sleep health score based on multiple sleep dimensions both enhanced the definition of cardiovascular health can be explained, at least in part, by the clustering of sleep problems. The study showed that individuals with a short sleep duration had higher chances of having low sleep efficiency (<85 percent time in bed after lights off spent sleeping), irregular sleep patterns (i.e., variable sleep duration and timing across days), excessive daytime sleepiness, and sleep apnea.  Notably, short sleepers also had higher prevalence of overweight/ obesity, type 2 diabetes, and hypertension, suggesting that multiple unhealthy sleep dimensions may occur concurrently and potentially interact, further increasing risk for heart disease.
 
“Healthcare providers should assess their patients’ sleep patterns, discuss sleep-related problems, and educate patients about the importance of prioritizing sleep to promote CVH,” noted Makarem. “Furthermore, the formal integration of sleep health into CVH promotion guidance will provide benchmarks for surveillance and ensure that sleep becomes an equal counterpart in public health policy to the attention and resources given to other lifestyle behaviors.”
 
“We recommend that additional research be conducted to examine the expanded definition of CVH that encompasses sleep in relation to lifetime risk of developing CVD. Clinical trials are also needed to evaluate the impact of screening for sleep problems and improving multiple dimensions of sleep health through sleep hygiene interventions on cardiovascular outcomes.”
 
David Goff, MD, PhD, director of the Division of Cardiovascular Sciences at the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health (NIH), agreed. “This study provides compelling evidence that sleep metrics are an important factor in cardiovascular health,” said Goff, who was not a part of the study team. “Recognizing sleep as an integral part of heart health is a transformative step toward reducing the global burden of cardiovascular disease, the leading cause of death, and reducing health disparities associated with it. We look forward to future research on sleep health that pursues the vision of healthy hearts on a healthy planet.”  

Co-authors are Marie-Pierre St-Onge and Brooke Aggarwal, Columbia University Irving Medical Center; Susan Redline, Brigham and Women’s Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School; Steven Shea, Columbia Mailman School of Public Health and Columbia University Irving Medical Center; Donald Lloyd-Jones and Hongyan Ning, Feinberg School of Medicine, Northwestern University.

The study was supported by National Heart, Lung, and Blood Institute (Grants R00-HL148511, R35 HL135818), National Institute on Minority Health and Health Disparities (Grant P50MD017341-01), American Heart Association (Grant #AHA855050, #AHA811531), National Institutes of Health (Grants R01HL128226 and R01HL142648). MESA is conducted and supported by the National Heart, Lung, and Blood Institute (Grants HHSN268201500003I, N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, N01-HC-95169, UL1-TR-000040, UL1-TR-001079, UL1-TR-001881, and DK06349, and HL098433.)

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Most of us know how important sleep is to anyone … without enough sleep and without enough quality sleep, you can find yourself suffering the consequences, whether you realize it or not. You may not be sleeping soundly, and you may not be getting into the different types of sleep everyone needs (think REM sleep and dreaming – essential to our overall health).

Sleep is a basic human need – not just for our physical bodies, but also for our mental health.

But enough about you. What about your children and teens? Children ages 6 to 12 need 9 to 12 hours, and teens 13 to 18 need 8 to 10 hours of good quality sleep. (The average teen only gets 7 to 7.5 hours.)

A teen’s natural sleep hormone melatonin is produced later at night, so they may have a harder time falling asleep at a reasonable time. Since they must usually get up early for school, they may have unintended consequences like trouble concentrating and lower grades. If they are driving, they may be drowsy while doing so. They may experience anxiety and depression as a result – they may even have thoughts of suicide.

As for younger children, starting as early as 3 months of age, higher levels of melatonin are produced at night, and lower levels are secreted during the daytime. In spite of this, up to 25% of healthy children have insomnia, and for those kids with neurodevelopmental and psychological disorders, about 75% experience insomnia. Kids also have trouble focusing, they are often hyperactive, irritable, have poor memories, feel anxious and depressed, and experience learning difficulties. All of which are reflected in their school performance.

What can you do?

Everybody – including kids and teens – needs vitamin D. It may also be helpful to take iron, calcium, magnesium, vitamin E, B vitamins, valerian, vitamin E, chamomile, and the amino acid theanine. Always work with a competent health care professional if you want to supplement with melatonin (even though you can purchase it over the counter).

Nix the soda, cakes, cookies, over-reliance on bread and pasta, etc. So, make sure you help your kids and teens dial back on the junk food. Also – read labels of products you purchase for your children – added chemicals for preserving or any other reason may be detrimental for their overall health, including their sleep patterns. If you want to purchase gummy vitamins please be aware that there is usually a significant amount of sugar in them, so these may not be the best choice.
However, if you improve the quality of their diets, especially in the salad and veggie department, you may be able to get most of these supplemental assists from the food itself!

Other tips for improving sleep are to turn off all screens at an earlier hour, make sure kids and teens get enough exercise, avoid eating close to bedtime, ensure bedrooms are dark, maintain a regular sleep schedule, avoid afternoon naps (or at least limit them to 15-20 minutes) as kids start getting older, limit caffeine intake (think chocolate, colas, coffee, etc.) and especially don’t eat or drink them at night. They’re stimulants! When summer break is coming to an end, and before school starts, begin setting an earlier-to-bed schedule.

If your child or teen seems troubled, and especially if they’re not talking to you about it, don’t hesitate to try some mental health counseling. You, as parents, can also take a look at your parenting style and see if you can improve your skills which may help your kids even more.

As always – have a happy, holistically healthy day!

Donna Poppendieck
Health and Wellness Online, LLC
+1 6142097889

–EINPresswire.com

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