Sleep matters: duration, timing, quality and more may affect cardiovascular disease risk
Embargoed until 4:00 a.m. CT/5:00 a.m. ET Monday, April 14, 2025
( NewMediaWire ) - April 14, 2025 - DALLAS — Healthy sleep includes multiple components, such as number of hours of sleep per night, how long it takes to fall asleep, daytime functioning and self-reported sleep satisfaction, and addressing these different dimensions of sleep may help to reduce cardiometabolic health and related risk factors, according to a new American Heart Association scientific statement published today in Circulation: Cardiovascular Quality and Outcomes.
The new scientific statement, 'Multidimensional Sleep Health: Definitions and Implications for Cardiometabolic Health,' describes multiple components of sleep health, such as sleep duration, continuity, timing, satisfaction, regularity and daytime functioning. The scientific statement also reviews the latest evidence on what is known about the relationship between sleep and various cardiometabolic health factors, including body fat, blood sugar, cholesterol and blood pressure, and how healthy sleep positively impacts physical health and mental well-being.
'Most adults need 7 to 9 hours of sleep each night, and suboptimal sleep raises the risk for cardiovascular disease, along with risk of cognitive decline, depression, obesity, as well as high blood pressure, blood sugar and cholesterol levels,' said Chair of the scientific statement writing group Marie-Pierre St-Onge, Ph.D., C.C.S.H., FAHA, an associate professor of nutritional medicine in the department of medicine and director of the Center of Excellence for Sleep & Circadian Research, both at Columbia University Irving Medical Center in New York City. 'However, there is increasing evidence that sleep health is about more than the number of hours you sleep each night.'
Sleep and cardiometabolic health
According to the scientific statement, no single facet of sleep health fully captures people's sleep experiences and how their individual body responds. The less-discussed and less-studied components of sleep health are relevant to the sleep experience and contribute to overall physical and mental health and well-being. Sleep components include:
Differences in sleep health
The statement also addresses differences in sleep health for people affected by adverse social drivers of health. A recent review of more than 300 studies found consistent associations between lower socioeconomic status and suboptimal sleep health. Social and environmental factors, including home and neighborhood characteristics such as light, air and noise pollution and safety, also contribute to differences in one or more components of sleep health.
Compared with non-Hispanic white people, individuals in historically underrepresented racial and ethnic groups sleep less and are more likely to experience worse sleep continuity, less satisfaction with sleep, later bedtimes, more irregular sleep, higher daytime sleepiness and a higher occurrence of sleep disorders . These differences are observed across the life span and persist over time, with Black adults having the worst sleep health among all people.
'It's important to know that every individual has different sleep experiences, and these differences may contribute to other health inequities,' said St-Onge. 'Including different components of sleep in discussions with patients provides essential information that can help health care professionals improve care.'
Asking questions such as 'How long does it typically take you to fall asleep each night?,' 'How many times do you wake up during the night?' and 'How often do you feel exhausted during the day?' can give patients the opportunity to share concerns about their sleep experience and quality of sleep. Documenting sleep details in the patient's medical records will help the patient's health care team to be informed about the patient's sleep health and may prompt more in-depth evaluation or screening. This information is also helpful when considering how a patient's health conditions and prescribed medication regimen may interfere with sleep health and need to be adjusted or changed.
'Some changes in sleep across the life course are natural, however, individuals should not accept poor or worsening sleep as a 'fact of life' or unavoidable consequence of the aging process. If they note new difficulties falling or staying asleep, or excessive daytime sleepiness, they should discuss this with their doctor for further evaluation and potential treatment,' said St-Onge.
More research needed to optimize sleep health
Awareness of the importance of sleep is growing, however, more research about the various dimensions of sleep health is needed so that clinicians can support patients with ways to promote healthy sleep and improve health. While there are numerous smartwatches and other personal devices available to track the amount of time spent asleep per night, advances in ways to assess other sleep dimensions are needed. Using data from both self-reported and objective measures can help ensure sleep health guidance is grounded in reliable and comprehensive information.
Sleep is one of the health metrics noted in Life's Essential 8, the American Heart Association's measures for optimal cardiovascular health. When incorporating sleep into the Life's Essential 8 score, the only measure for sleep is its duration (number of hours per night) because there isn't enough validated research yet confirming how to assess other sleep components.
According to some research studies, poor sleep health (such as short sleep duration and irregular sleep schedules) contributes to adverse cardiovascular outcomes. There is a need for evidence from clinical trials confirming that improving sleep health leads to better cardiometabolic health. This data could be useful in developing effective interventions to help people improve various components of their sleep, which, in turn, supports better cardiometabolic health.
Research studies on multidimensional sleep health would ideally include collaborative efforts across medical specialties, including sleep medicine, cardiology, endocrinology, gastroenterology, nephrology, pulmonology and neurology. In addition, individuals from under-represented racial and ethnic groups should be included in studies to capture the various components of sleep health in diverse populations and communities. Broader understanding and validated research about the impact of sleep on physical health and mental well-being are key to advancing cardiovascular health for all.
This scientific statement was prepared by the volunteer writing group on behalf of the American Heart Association's Council on Lifestyle and Cardiometabolic Health; the Council on Cardiovascular and Stroke Nursing; the Council on Clinical Cardiology; and the Council on Quality of Care and Outcomes Research. American Heart Association scientific statements promote greater awareness about cardiovascular diseases and stroke issues and help facilitate informed health care decisions. Scientific statements outline what is currently known about a topic and what areas need additional research. While scientific statements inform the development of guidelines, they do not make treatment recommendations. American Heart Association guidelines provide the Association's official clinical practice recommendations.
Additional members of the statement writing group and co-authors are Vice-Chair Michael A. Grandner, Ph.D., M.T.R, M.S., FAHA; Brooke Aggarwal, Ed.D., M.S., FAHA; Julio Fernandez-Mendoza, Ph.D.; Dayna Johnson, Ph.D., M.P.H., M.S.W., M.S.; Christopher E. Kline, Ph.D., M.S.; Kristen L. Knutson, Ph.D., FAHA; and Nancy Redeker, Ph.D., R.N., M.S.N., FAHA. Authors' disclosures are listed in the manuscript.
The Association receives more than 85% of its revenue from sources other than corporations. These sources include contributions from individuals, foundations and estates, as well as investment earnings and revenue from the sale of our educational materials. Corporations (including pharmaceutical, device manufacturers and other companies) also make donations to the Association. The Association has strict policies to prevent any donations from influencing its science content. Overall financial information is available here.
Additional Resources:
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About the American Heart Association
The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public's health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1.
For Media Inquiries: 214-706-1173
Michelle Kirkwood: [email protected]
For Public Inquiries: 1-800-AHA-USA1 (242-8721)
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