In the study, Trajectories of Sleep Over Midlife and Incident Cardiovascular Disease Events, SWAN researcher Rebecca Thurston, Ph.D., sought to further the understanding of the importance of sleep for health. The breadth of the SWAN cohort provided a unique opportunity to consider how sleep patterns over two decades of life are related to clinical outcomes such as heart attack and stroke later in life.
Midlife, which includes the menopause transition, is a time of vulnerability to poor sleep as well as of degrading cardiovascular health for many women. The study shows that poor sleep is more than a nuisance and it may have major implications for heart health. The SWAN study, highlighted in this video by ESC 365, is the first to demonstrate that a trajectory of chronic insomnia symptoms over two decades of midlife is associated with elevated risk for cardiovascular disease (CVD) events later in life in women. The impact of these insomnia symptoms on CVD risk is most pronounced among women who also have chronically short sleep duration. The relationships of insomnia symptoms to women’s cardiovascular health are not explained by CVD risk factors, sleep apnea symptoms, mood, or vasomotor symptoms.
Details of the study show that many women had chronic insomnia symptoms over two decades midlife. Some of these women chronically got less than five hours of sleep a night. Women with chronic insomnia symptoms had an increased risk of a heart attack, stroke, or other CVD event in later midlife, after accounting for CVD risk factors such as hypertension or obesity. Women with chronically short sleep had an increased risk of a CVD event, and women with both chronic insomnia symptoms and short sleep had an even higher increased risk of a CVD event after accounting for CVD risk factors. These data indicate that chronically poor sleep is common, impacting almost a quarter of women over midlife, and that this chronically poor sleep places women at risk for CVD events later in life.
This research is important given the sheer magnitude of women impacted by this issue – sleep problems are very common among midlife women. In addition, CVD is the leading cause of death in women. This research importantly brings these two topics together by providing a unique perspective on those who experience insomnia symptoms and/or short sleep persistently over midlife and their future risk for CVD.
Trajectories of Sleep Over Midlife and Incident Cardiovascular Disease Events was presented at The Menopause Society annual meeting in 2023. The study will hopefully lead to steps to reduce CVD risk not only targeting things like blood pressure, obesity, or diabetes, but will also seek to improve sleep among those with poor or short sleep. Next steps in this area of research are to determine whether treating sleep problems improves cardiovascular health.
