You’ve heard the expression “the early bird gets the worm.” According to new research, the early bird may also have a lower risk of heart disease. A study published in Journal of the American Heart Association determined that “nighters,” or people who stay up late, have a higher risk of heart disease and other negative cardiovascular health outcomes.
Meet the experts: Allen Taylor, MD, cardiologist and chairman of cardiology at the MedStar Heart and Vascular Institute; Carleara Weiss, Ph.D., MS, RN, sleep scientist, assistant professor at the State University of New York and sleep educator at Aeroflow Sleep.
Over a roughly 14-year period, the researchers examined the health data of nearly 323,000 participants, ages 39 to 74, who were predominantly white, male and initially free of known cardiovascular disease. They self-reported their sleep patterns and were scored based on their adherence to the American Heart Association’s Life Essential Eight (LE8) elements for good heart health: balanced diet, physical activity, low nicotine exposure, quality sleep, adequate body mass index, blood lipids, blood glucose, and blood pressure measurements. A high score means good adherence and a low score means poor adherence.
After an average of 14 years, the researchers identified the prevalence of heart attacks and strokes in the participants and compared the cases to their LE8 scores. Those who self-proclaimed night owls and had lower scores were among the most affected by cardiac events, leading the researchers to determine that night owls had a 16 percent higher risk of having a heart attack or stroke compared to “determined” morning people or those who had an “intermediate sleep-wake preference,” meaning they fell somewhere between a morning owl.
Specifically, the researchers identified that the night owls’ increased risk of heart disease was largely driven by a poor diet, high nicotine consumption, poor sleep, infrequent exercise, high body weight, and uncontrolled blood sugar.
However, “When these risk factors were statistically accounted for, the excess cardiovascular risk associated with being a night owl was largely eliminated,” says Allen Taylor, MD, cardiologist and chairman of cardiology at the MedStar Heart and Vascular Institute. This means the findings point to an association, rather than causation, between delayed sleep and heart health. But sleep remains an important pillar.
How sleep affects heart health
Each individual’s circadian rhythm varies slightly, but the human brain is largely influenced by light (or the lack of it) to release the hormones needed to wake up and fall asleep, which is why most of us feel tired when it gets dark and energized by sunlight. So it makes sense that resisting such a natural cycle would encourage poor health.
“Sleep supports cardiovascular health through physiological changes in heart rate and blood pressure,” says Carleara Weiss, Ph.D., MS, RN, sleep scientist, assistant professor at the State University of New York and sleep educator at Aeroflow Sleep.
“Adequate sleep duration and quality also regulate immune function and hormone levels and reduce the inflammatory response,” adds Weiss. “Oxygen saturation is another important aspect of sleep, and cardiovascular health is adversely affected in people with untreated obstructive sleep apnea.” (Sleep apnea is characterized by a lack of oxygen during sleep.)
Sleep also regulates the hormones ghrelin, which signals hunger, and leptin, which signals satiety, she explains. Therefore, poor sleep can trigger cravings for high-fat and processed foods, promoting weight gain and thus potentially leading to negative effects on heart health.
How to sleep better
“Behavioral changes are often the first step in readjusting sleep and circadian rhythms,” says Weiss. This could mean changing your bedtime or using light therapy when needed to encourage your body to wake up (such as the Hatch alarm clock). Of course, changing modifiable LE8 factors like diet and exercise can inherently improve lifestyle and sleep routines, Dr. Taylor notes. Everything is connected.
However, there are specific cases, such as night shift workers and people with delayed sleep phase syndrome, for example, who may need assistance from a health care provider to ensure quality sleep, Weiss says.
The bottom line
By instituting positive cardiovascular health habits (such as getting good sleep, eating a nutritious diet, reducing stress, etc.), the risk associated with a nighttime sleep schedule “can be substantially reduced or eliminated,” says Dr. Taylor. In other words, following heart-healthy habits—which include good sleep—is more important than When you hit the hay.
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