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Insomnia linked to increased risk of heart failure

Filed in
  • Insomnia
  • mortality

By Lynn Celmer  |  Mar 06, 2013
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A new study found that people who suffer from insomnia appear to have an increased risk of developing heart failure.

"We related heart failure risk to three major insomnia symptoms including trouble falling asleep, problems staying asleep, and not waking up feeling refreshed in the morning," said Dr. Lars Laugsand, a post-doctoral fellow in the Department of Public Health, Norwegian University of Science and Technology in Trondheim, Norway. "In our study, we found that persons suffering from insomnia have increased risk of having heart failure. Those reporting suffering from all three insomnia symptoms simultaneously were at considerably higher risk than those who had no symptoms or only one or two symptoms."

However, Dr. Laugsand stressed that although the study shows that insomnia is linked to an increased risk of heart failure, it does not show that it causes it. "We do not know whether heart failure is really caused by insomnia, but if it is, insomnia is a potentially treatable condition using strategies such as following simple recommendations concerning sleeping habits (often referred to as sleep hygiene), and several psychological and pharmacological therapies. Evaluation of sleep problems might provide additional information that could be used in the prevention of heart failure."

He said further research would be required to establish whether or not insomnia caused the condition. "It is still unclear why insomnia is linked to higher heart failure risk. We have some indications that there might be a biological cause, and one possible explanation could be that insomnia activates stress responses in the body that might negatively affect heart function. However, further research is also needed to find the possible mechanisms for this association."

The study, which is published online today in the European Heart Journal, followed 54,279 people between the ages of 20-89 for an average of more than 11 years, and found that those who suffered from three symptoms of insomnia had a more than three-fold increased risk of developing heart failure compared to those with no insomnia symptoms.

When participants joined the study they were asked whether they had difficulty going to sleep and staying asleep, with the possible answers being "never", "occasionally", "often" and "almost every night". They were also asked how often they woke up in the morning not feeling refreshed (non-restorative sleep): "never, "few times a year", "one to two times per month", "once a week", "more than once a week."

After adjusting for factors that could affect the results, such as age, sex, marital status, education, shift work, blood pressure, cholesterol, diabetes, body mass index, physical activity, smoking, alcohol, any previous heart attack, depression and anxiety, the researchers found that having difficulties going to sleep and staying asleep almost every night, and having non-restorative sleep more than once a week were associated with an increased risk of heart failure when compared with people who never or rarely suffered from these symptoms. There was a trend showing a link between the frequency of the symptoms and the increased risk, although most of these findings did not reach statistical significance.

When they looked at the number of symptoms, the researchers found a statistically significant three-fold (353%) increased risk of heart failure for people who had all three insomnia symptoms, compared to those with none, after adjusting for most confounding factors apart from depression and anxiety. When they adjusted their findings to include depression and anxiety, the risk was still significant, with a slightly more than four-fold risk (425%) of heart failure.

The American Academy of Sleep Medicine considers sleep disorders an illness that has reached epidemic proportions. Board-certified sleep medicine physicians in an AASM-accredited sleep center provide effective treatment. AASM encourages patients to talk to their doctors about sleep problems or visit www.sleepeducation.com for a searchable directory of sleep centers.


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