1. Self-reported and clinically diagnosed poor sleep are associated with lower cardiovascular disease-free life expectancy, compared to patients with healthy sleep.

Evidence Rating Level: 2 (Good)

Poor sleep has been associated with greater risk of cardiovascular disease (CVD). A previous study found a 39% greater risk of CVD mortality in poor sleepers compared to healthy sleepers. However, there is a paucity of evidence pertaining to the association between sleep and CVD-free life expectancy at age 40. Therefore, this cohort study estimated the CVD-free years of life lost for patients with self-reported and clinically diagnosed poor sleep. The study population was taken from the UK Biobank. Each participant completed a baseline sleep questionnaire, with a 5-point score assigned based on insomnia, sleep duration (adequate being 7-9 hours), chronotype in the morning, daytime drowsiness, and snoring. The tallied scores were categorized into healthy sleep (4-5 points), intermediate sleep (2-3 points), and poor sleep (0-1 points). Additionally, health records were used to identify primary care encounters, hospital admissions, and prescriptions related to sleep disorders, such as insomnia, hypersomnia, circadian rhythm disorders, parasomnias, and sleep-related breathing disorders. CVD events were measured using CVD-related hospital admissions, with separate analyses conducted for men and women due to their differences in CVD risk. In total, there were 308,683 patients in the self-reported sleep analysis, and 140,181 in the clinically diagnosed sleep disorder analysis. The study found a lower CVD-free life expectancy at age 40 in patients with self-reported poor sleep compared to healthy sleep, with a difference of 1.80 (95% CI 0.96-2.75) years in women and 2.31 (95% CI 1.46-3.29) years in men. The hazards ratios for CVD in poor versus healthy sleepers were 1.13 (95% CI 1.05-1.22) in women and 1.17 (95% CI 1.09-1.26) in men. Additionally, there was a difference of 1.16 (95% CI 0.43-2.21) CVD-free years lost between those with clinically diagnosed sleep disorders, compared to those without. Overall, this study demonstrated that self-reported and clinically diagnosed poor sleep are associated with lower CVD-free life expectancy.

Click to read the study in BMC Medicine

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