Insomnia associated with
increased risk of heart attack and stroke
INSOMNIA is associated with increased
risk of heart attack and stroke, according to research published in the European
Journal of Preventive Cardiology. "Sleep is important for biological recovery and takes around a third of
our lifetime, but in modern society more and more people complain of insomnia..."
said 1st author Qiao He, a Master's degree student at China Medical
University, Shenyang, China. "For example, it is reported that
approximately ⅓ of the general population in
Germany has suffered from insomnia symptoms. Researchers have found associations
between insomnia and poor health outcomes. But the links between insomnia and
heart disease or stroke have been inconsistent."
The current meta analysis assessed the association between insomnia symptoms and
incidence or death from cardiovascular disease (acute myocardial infarction,
coronary heart disease, heart failure), stroke, or a combination of events.
Insomnia symptoms included difficulty initiating sleep, difficulty maintaining
sleep, early morning awakening, and non restorative sleep.
The authors analysed 15 prospective cohort studies with a total of 160 867
participants. During a median follow up of three to 29.6 years, there were 11
702 adverse events.
There were significant associations between difficulty initiating sleep,
difficulty maintaining sleep, and non restorative sleep and the risk of heart
disease and stroke, with increased relative risks of 1.27, 1.11, and 1.18,
respectively, compared to those not experiencing these insomnia symptoms. There
was no association between early morning awakening and adverse events.
Miss He said:- "We found that difficulty initiating sleep, difficulty
maintaining sleep, or non restorative sleep were associated with 27%, 11%, and
18% higher risks of cardiovascular and stroke events, respectively. The underlying mechanisms for these links are not completely understood. Previous studies have shown that insomnia may change
metabolism and endocrine function, increase sympathetic activation, raise blood
pressure, and elevate levels of proinflammatory and inflammatory cytokines; all
of which are risk factors for cardiovascular disease and stroke."
Women with insomnia symptoms had a slightly higher risk of cardiovascular and
stroke events than men, especially for non restorative sleep, but the difference
between sexes did not reach statistical significance.
Miss He said:- "We cannot conclude that insomnia is more dangerous for
women, given the limitations of meta analyses and the lack of a statistically
significant difference between sexes. However, we do know that women are more
prone to insomnia because of differences in genetics, sex hormones, stress, and
reaction to stress. It may therefore be prudent to pay more attention to women's
Miss He concluded:- "Sleep disorders are common in the general population
and sleep health should be included in clinical risk assessment. Health
education is needed to increase public awareness of insomnia symptoms and the
potential risks, so that people with sleep problems are encouraged to seek