Disturbed sleep associated with a higher risk of death, especially in women: A study

The findings of the study were published in the European Heart Journal.
A study of 8001 men and women found that adult women who most often had unconscious wakefulness and for long periods of time had almost double the risk of dying from cardiovascular disease during an average follow-up between 6 and 11 years compared to the risk in the general female population.
The association was less clear in men, and the risk of cardiovascular death increased by just over a quarter compared to the general male population.
Unconscious awakening, also known as cortical arousal, is a normal part of sleep. It occurs spontaneously and is part of the body’s ability to react to potentially dangerous situations, such as noise or breathing obstruction. Pain, limb movements, trauma, temperature and light can also be triggers.
Dominik Linz, associate professor in the Department of Cardiology at the University Medical Center Maastricht (Netherlands), explained: Another cause of arousal may be “noise pollution” during the night, for example, the night noise of aircraft. Depending on the strength of the arousal, a person may become consciously aware of the environment, but this is often not the case. Usually people will feel exhausted and tired in the morning due to sleep fragmentation, but they will not be aware of individual excitements. “
Previous research has shown that sleep duration, either too short or too long, is associated with an increased risk of death due to cardiovascular or other causes. However, it has not been known so far whether there is a relationship with the burden of arousal (a combination of the number of arousals and their duration) during nighttime sleep and the risk of death.
In collaboration with a team led by Associate Professor Mathias Baumert from the Faculty of Electrical and Electronic Engineering at the University of Adelaide (Australia) and prof. Linzom, the researchers looked at data from sleep monitors worn by men and women overnight by men and women participating in one of three studies: 2,782 men in the Osteoporotic Fracture Study in Men (MrOS), 424 women in the Osteoporotic Fracture Study (SOF) and 2221 men and 2574 women in the Sleep Heart Health Study (SHHS). The average age in the studies was 77, 83 and 64 years, respectively. Participants were monitored over a period of several years, ranging from an average of six years (SOF) to 11 years (MrOS).
After adjusting for factors that could affect outcomes such as total sleep duration, age, medical history, body mass index (BMI), and smoking habits, the researchers found that women had a lower arousal burden than men. However, those who had an arousal burden of more than 6.5 percent of nighttime sleep had a higher risk of dying from cardiovascular disease than women with a lower arousal load: twice the risk of SOF and 1.6 times the risk of SHHS. The risk of dying from all causes was also increased 1.6-fold in SOF and 1.2-fold in SHHS.
Taking women from both studies together, those with an arousal burden greater than 6.5 percent had a 12.8 percent risk of dying from cardiovascular disease, nearly twice as many as women of similar age in the general population who had a 6.7 percent risk. The risk of dying from any cause was 21 percent among women in the general population, which increased to 31.5 percent among women in two studies with a burden of arousal greater than 6.5 percent.
Men with a load of arousal who make up more than 8.5 percent of nighttime sleep were 1.3 times more likely to die from cardiovascular disease (MrOS) or any cause (SHHS) than men with a lower load of arousal, but found for the increased risk of death from any cause of MrOS or cardiovascular disease in SHHS were not statistically significant.
When the researchers looked at all men in both studies, those with an arousal burden greater than 8.5 percent had a risk of 13.4 percent, or 33.7 percent, of dying from cardiovascular disease or any other cause, compared with the risk in general a population of men of similar age of 9.6 percent and 28 percent, respectively.
Professor Linz said: “It is unclear why there is a difference between men and women in associations, but there are some potential explanations. Triggers that cause arousal or the body’s response to arousal may differ in women compared to men. This may explain the relatively higher risk of cardiovascular deaths in women. Women and men may have different compensatory mechanisms to deal with the harmful effects of arousal. Women may have a higher arousal threshold, and this may result in a higher workload in women compared to men. “
He said that older age, BMI and the severity of sleep apnea increase the load of excitement. “Although age cannot be changed, BMI and sleep apnea can be modified and can be an interesting goal to reduce the burden of arousal. Whether this translates into a lower risk of dying from cardiovascular disease requires further study. For me as a doctor, great arousal The burden helps identify patients who may be at higher risk of cardiovascular disease.We must advise our patients to take care of their sleep and practice good ‘sleep hygiene.’ Measures to minimize noise pollution during the night, weight loss and treatment of sleep apnea can also help to the burden of excitement is reduced. “
Professor Baumert said, “To incorporate excitation load assessment into routine strategies to reduce the risk of cardiovascular disease, we need easily scalable, widely available and affordable techniques for estimating sleep duration and fragmentation and for detecting excitement. Portable devices for measuring activity and change in breathing patterns can provide important information. ”
Limitations of the study include that it was conducted on older, mostly white people, and therefore its findings cannot be extrapolated to other races or younger men and women. The researchers did not consider the possible effect of the drugs; participants’ sleep monitoring was performed overnight and thus did not take into account night-to-night variations. Finally, it can only show that there is an association between a higher burden of sleep arousal and an increased risk of death, rather than that sleep arousal causes an increased risk.
In the accompanying editorial, Professor Borja Ibanez, director of clinical research at the Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid (Spain), and colleagues who were not included in the study write that the strength of the study is that the burden of arousal is objectively measured by sleep monitors. , instead of being reported by the participants themselves. They point out that it is known that a disorder of the natural circadian rhythm in the body is involved in the development of often undetected accumulations of fat in the arteries, and this could be a possible mechanism for increasing the risk of cardiovascular problems.
They continued, “Although there are many gaps in knowledge about the connection between sleep and CVD [cardiovascular disease] which will be further studied in the coming years, this study provides solid evidence confirming the importance of sleep quality for better CV health. Further evidence combining a comprehensive sleep assessment with biological sampling and long-term follow-up will be desirable. . . What remains to be determined is whether an intervention aimed at improving sleep quality is able to reduce the incidence of CV events and mortality. While we wait for these tests, we wish you sweet dreams. “(ANI)