Short sleep duration, insomnia worsen heart health for midlife women

Key takeaways :

• Insomnia and short sleep duration significantly increase CV risk for midlife women.
• Almost 25% of premenopausal and early perimenopausal women reported persistently poor sleep.

PHILADELPHIA — Midlife women with persistently poor sleep are at elevated risk for CV events, particularly when they experience insomnia and sleep no longer than 5 hours per night, according to study data.

“Sleep is not solely a quality of life issue,” Rebecca C. Thurston, PhD, FABMR, FAPS, director of the women’s biobehavioral health program, director of the cardiovascular behavioral medicine research training program and professor of psychiatry, psychology, epidemiology, and clinical and translational science at the University of Pittsburgh, told Healio. “Persistently poor sleep is common among midlife women, and it has implications for women’s heart health.”

Thurston presented findings based on an analysis of data from the Study of Women’s Health Across the Nation (SWAN) at the Annual Meeting of The Menopause Society.

Thurston and colleagues analyzed data from questionnaires completed by 3,016 premenopausal or early perimenopausal women (48% white, 28% Black, 8% Chinese, 9% Japanese, 7% Hispanic) aged 42 to 52 years at baseline who did not have CVD and who were not using hormone therapy. Over 22 years, participants responded up to 16 times to questions about symptoms related to insomnia, such as trouble falling asleep and waking during the night or earlier than desired; sleep duration; vasomotor symptoms; depressive symptoms; BMI; blood pressure; and CVD.

The researchers identified four courses of insomnia: 38.5% of participants reported few insomnia symptoms during the study period, 19% reported moderate insomnia that lessened over time, 19.9% reported moderate insomnia that worsened over time and 22.6% reported persistent insomnia.

In addition, 14% of participants reported routinely sleeping about 5 hours per night (short sleep duration), 58% about 6 hours per night (moderate duration) and 28% about 8 hours per night (long duration).

The researchers determined that midlife women who reported persistent insomnia had increased risks for CVD events, including fatal or nonfatal myocardial infarction, stroke, heart failure and revascularization (HR = 1.9; 95% CI, 1.33-2.71; P .01) compared with their peers who had few insomnia symptoms. Similarly, those with shortest sleep duration had increased CVD risks (HR = 172; 95% CI, 1.13-2.62; P .05). When persistent insomnia was present with short sleep duration, CVD risk rose compared with those reporting few insomnia symptoms and moderate to long sleep duration (HR = 1.75; 95% CI, 1.08-2.98; P .05). The associations remained after adjusting for vasomotor symptoms, snoring and depressive symptoms.

“Too often we treat sleep as a luxury,” Thurston told Healio. “However, prioritizing sleep is critically important not only for mental health, but also for physical health.”