???? Your sleep impacts your cardiovascular health, it’s proven

2023-10-27 04:00:08

The association between sleep disorders and cardiovascular risk is already well documented. Apnea, sleep deficit, or even insomnia are linked to an increased risk of cardiovascular diseases or accidents. But a new study published in l’European Heart Journal goes much further in the exploration of this association.
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Led by the team of Jean-Philippe Empana, Inserm research director, within the Cardiovascular Research Center in Paris (Inserm/Université Paris Cité), in collaboration with the University Hospital Center (A university hospital center (CHU) is a hospital linked to a university,…) in Vaud (CHUV, Lausanne), this study shows that five components of sleep weigh heavily almost equivalent in the association with the risk of coronary events and stroke, and that improving one of these over time can provide a significant benefit. These components are the duration of sleep each night, the chronotype (being morning or evening), the frequency (In physics, frequency generally refers to the measurement of the number of times that a…) of insomnia, excessive daytime sleepiness and sleep apnea.

Sleep is essential for health and well-being, and several physiological mechanisms underlie this. Thus, poor quality or quantity of sleep is associated with a deterioration in health: mood problems, depression, weight, infections, diabetes, hypertension. .. A link has been established in particular with cardiovascular risk and the Inserm team led by Jean-Philippe Empana, at the Cardiovascular Research Center in Paris, wanted to explore this point further.

To do this, she studied the risk of cardiovascular accidents (acute coronary syndrome or stroke) in relation to five components of sleep: the duration of sleep each night, the chronotype (being morning or evening), the frequency of insomnia, excessive daytime sleepiness and sleep apnea.

“Usually, studies focus on a single dimension of sleep, mainly the duration of sleep or the presence of sleep apnea, but good sleep or healthy sleep encompasses several dimensions”, clarifies Aboubakari Nambiema, first author of this work and postdoctoral researcher at Inserm.

The researchers integrated these five dimensions into a single score in order to account for the multifactorial nature of sleep. Each of them is evaluated using a specific questionnaire validated by the scientific community (A scientist is a person who devotes himself to the study of a science or sciences and who…) and adapted to large studies ( Pittsburgh sleep quality index-PSQI, Berlin questionnaire or Epworth Sleepiness Scale) and counts for 1 point when it is optimal or 0 points otherwise. The overall score thus varies from 0 (worst score) to 5 (optimal score corresponding to: 7 to 8 hours of sleep per night, being a morning person, not having insomnia, apnea or excessive sleepiness during the day) .

Monitoring over time

This score was used in two population surveys intended to study the determinants of cardiovascular health.

One was conducted in Paris and included 10,157 adults aged 50 to 75 (Paris prospective study no. 3, EPP3). The other was conducted in Switzerland in Lausanne and brought together 6,733 participants over the age of 35 via the CoLaus|PsyCoLaus study of the Vaud University Hospital Center (CHUV).

The score was calculated at inclusion then two to five years later. The occurrence of cardiovascular events was then monitored for approximately 8 to 10 years. “The use of a composite score to study sleep habits had already been experimented in the past but this is the first time to our knowledge that a study is interested in its evolution over time and its potential association with cardiovascular diseases”, explains Jean-Philippe Empana.

By combining the data from the two surveys, a first analysis confirms that the higher the initial score (at entry into the study), the lower the risk of cardiovascular accident. Compared to people who have a score of 0-1 (10% of participants), the risk of cardiovascular pathologies is reduced by 10% for participants who have a score of 2 (21% of participants), 19% for those who have a score of 3 (32%, the majority of participants), 38% for a score of 4 (27% of participants) and 63% for those with the best score of 5 (10% of participants). “In other words, nearly 60% of cardiovascular accidents might potentially be avoided if individuals all had an optimal sleep score (score of 5), thus underlining the potential public health implications of the results,” clarifies Jean-Philippe Empana.

A second analysis focusing for the first time on the evolution of the sleep score over time shows that sleep improved in 8% of participants, deteriorated in 11% and remained stable in the majority of participants (2/ 3 of them remained with a score equal to or greater than 3). Importantly, these changes are associated with the occurrence of cardiovascular pathologies. In particular, this risk decreased by 16% for each score point gained over time, regardless of which component of the score was improved. “Each one seems to be as important as the others,” says Aboubakari Nambiema.

The researchers now hope that health professionals and the general population will take advantage of this tool: “the ease and speed of using the questionnaires as well as the simplicity of calculating the sleep score should promote their understanding and good adherence “, they predict.

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