Prioritize, optimize sleep to reap cardiometabolic benefits
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Key takeaways:
- Poor sleep habits are linked to greater CV and metabolic risk.
- Improving sleep by 30 minutes per day can improve blood pressure and glucose regulation.
BOSTON — Simple steps to optimize poor sleep habits can translate to large gains in cardiometabolic health, including improvements in BP, insulin resistance and even appetite regulation, according to a speaker.
Most adults do not get the optimal 7 to 9 hours of recommended daily sleep time, with the prevalence of adults reporting short sleep approaching 40% in the U.S., Sirimon Reutrakul, MD, professor of medicine in the department of biobehavioral nursing science at the University of Illinois of Chicago College of Nursing, said during a presentation at the Cardiometabolic Health Congress. The detrimental effects of short sleep accumulate over time, Reutrakul said; data show gradual increases in sympathetic nervous system activity, inflammation, heart rate, insulin resistance and even increased appetite and caloric intake. Risks are similar for people with disrupted sleep from activities such as shift work.
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“Evidence shows that people know sleep is important to health but don’t prioritize it as high as other aspects of health or life, like exercise, diet or work,” Reutrakul told Healio. “Raising awareness about sleep and heart health hopefully will get people engaged in the conversation and potentially more motivated to prioritize sleep. Simple steps can start with following sleep hygiene.”
Highlighting importance of sleep
Professional associations are beginning to highlight the importance of sleep in overall cardiometabolic health. In June 2022, the American Heart Association updated its popular Life’s Simple 7 checklist — now called Life’s Essential 8 — to include sleep health metrics, Reutrakul said, noting that inappropriate sleep duration (either shorter or longer than ideal) is associated with CHD. Epidemiological studies have identified poor habitual sleep as a risk factor for all-cause mortality and subsequent research has explored potential mechanisms, including implications for cardiometabolic health.
Reutrakul said clinicians discussing sleep health with patients should look at several components, including sleep duration, quality, timing and regularity, as well as considering an evaluation for obstructive sleep apnea, which is especially common in people with diabetes, Reutrakul said.
“These dimensions, each by itself or in combination, contribute to CV health, such as BP, diabetes, stroke, coronary heart disease and even mortality,” Reutrakul told Healio. “Sleep optimization has been shown to potentially improve cardiovascular health.”
Sleep interventions to reduce risk
Sleep is related to multiple social and psychological factors, Reutrakul said. A person’s environment, including noise level, light exposure and neighborhood safety, as well as social determinants of health, health disparities and depression and anxiety all play a role in sleep duration and quality.
In a study published in Sleep Medicine Reviews in 2021, researchers examined the effects of behavioral sleep extension interventions on sleep duration outcomes in children and adults. In the meta-analysis, researchers found that behavioral sleep extension, accomplished via behavioral change techniques like shaping knowledge, goals and planning, feedback and monitoring and social supports, resulted in a significantly higher sleep duration compared with controls or baseline sleep time.
“Can we ask people to sleep more?” Reutrakul said. “The answer is, ‘yes.’”
Other data assessing sleep extension for chronic short sleepers suggest increasing sleep time by about 30 minutes per day during a 2-week sleep extension intervention is associated with improvements in insulin resistance, BP and even reductions in caloric intake and cravings for sweet or salty foods, Reutrakul said.
“Sleep extension is tailored to behavior,” Reutrakul said. “Most people curtail their sleep; sleep is the last thing they think about. We have to [set] a goal so they can increase sleep time.”
The American Academy of Sleep Medicine provides recommendations for ideal sleep habits, which include getting at least 7 hours of sleep daily, avoiding going to bed unless sleepy, establishing a relaxing bedtime routine, avoiding alcohol or caffeine before bed and turning off electronic devices.
Keeping sleep times consistent, no matter the time of day one goes to bed, is also key to improving health metrics, Reutrakul said.
“Keep a consistent sleep schedule, even on the weekends,” Reutrakul said.
Reference:
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Reutrakul S. The intersection of sleep and cardiometabolic risk. Presented at: Cardiometabolic Health Congress; Oct. 18-21, 2023; Boston.
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