With our busy lives, it can be tempting to shrug off—or ignore altogether—difficulties with sleep. Trouble falling asleep, difficulty staying asleep throughout the night, waking feeling tired and unrefreshed: these are commonly experienced disruptions to sleep for millions of adults. Too often, these sleep problems aren’t taken seriously, or are considered the less-than-ideal price to pay for living full and sometimes hectic lives.
Difficulty falling asleep, waking during the night, waking very early in the morning, and experiencing un-restorative sleep are all symptoms of insomnia, a serious sleep disorder. People may experience these symptoms all at once, or some of them and not others. They may experience them chronically or every so often. They are signs of disrupted, poor quality sleep and they should never be ignored.
New research indicates how high a price we may pay for overlooking signs of insomnia. Scientists at Massachusetts’ Brigham & Women’s Hospital have identified a link between insomnia symptoms and elevated risk of death. Their study, which included more than 23,000 men, found certain symptoms of insomnia associated with higher mortality risk from cardiovascular disease. The men were all participants in the Health Professionals’ Follow-Up Study, a long-term, ongoing research endeavor that investigates issues related to men’s health. In 2004, 23,447 men reported to researchers about their sleep and any insomnia symptoms. Researchers followed up with the men over a period of 6 years, during which time 2,025 of the men died. After adjusting for other mortality-influencing factors including age, lifestyle habits, and other health problems, researchers analyzed data on men’s mortality as related to the presence of the following insomnia symptoms:
- Trouble falling asleep
- Difficulty maintaining sleep
- Waking in the early morning
- Experiencing non-restorative sleep
They found that several symptoms of insomnia were associated with higher rates of cardiovascular death among the men. In particular:
- Men who reported having difficulty falling asleep had a 55% increased risk of death from cardiovascular disease as compared to those men who did not experience this sleep difficulty.
- Men who reported experiencing un-refreshing sleep most of the time were at 32% higher risk for cardiovascular death than men who did not report this symptom.
Poor sleep is well understood to have a serious, negative impact on heart health. Not sleeping well, or enough, raises the risks for a number of cardiovascular problems, including high blood pressure, heart attack, heart failure, and stroke. Protecting the quality of sleep as we age is a critical component of protecting long-term cardiovascular health.
This isn’t the first scientific evidence of a link between poor sleep and increased mortality risk. But the news is particularly worrisome because these symptoms are quite common, particularly as we age. Estimates suggest that 30% or more of American adults experience some insomnia symptoms at least periodically, and for 10-15%, insomnia is chronic. Insomnia grows increasingly common with age: more than half of adults over the age of 65 experience symptoms of insomnia. Women are at higher risk than men for insomnia, due in part to hormonal cycles during childbearing years and to the hormonal changes associated with menopause. This current study included only men, but other research has shown higher risks of mortality associated with poor sleep in both men and women:
- In a number of studies that included both men and women, sleeping fewer than 6 hours and more than 8 hours per night has been associated with increased mortality risk.
- Obstructive sleep apnea in men and in women is linked to significantly higher cardiovascular and overall mortality risks. Studies have shown that mortality risks from cardiovascular problems are 2 or more times greater for adults with obstructive sleep apnea. The more severe the obstructive sleep apnea, the greater the mortality risks.
- Research has also linked use of sleeping pills to increased mortality risk. The link between higher rates of mortality and sleeping pill use exists even after factoring out other possible contributors to death risk, including health problems, age, and gender.
Ready for some good news? While sleep problems left untreated may shorten longevity, improving sleep can have powerful positive health benefits. A study conducted recently in the Netherlands found that a regular routine of 7-8 hours of sleep may have as significant an impact on risk for cardiovascular death as not smoking. Regular, sufficient amounts of high-quality sleep have also been linked to reduced risk for type 2 diabetes, largely because of the positive effect that sleep can have on improving insulin sensitivity.
If you have symptoms of insomnia, don’t ignore them. Share them with your doctor. Make an honest assessment of your sleep habits and make a commitment to taking simple steps to improve your sleep routine and your overall sleep hygiene. Taking steps to improve the quality and quantity of your sleep is one important way to protect your cardiovascular and overall health for the duration of your life. And sleeping well may actually help you extend that duration.
Michael J. Breus, PhD
The Sleep Doctor™