Summary: New research indicates that poor sleep patterns may account for as much as 8% of deaths from any cause. People with healthier sleep habits appear incrementally less likely to die prematurely.
Source: American College of Cardiology
Sleep quality is increasingly recognized as a key factor in heart health and overall longevity. Research presented at the American College of Cardiology’s Annual Scientific Session Together With the World Congress of Cardiology finds that better sleep habits are associated with lower risk of premature death.
The study reports that individuals—especially younger adults—who practice more beneficial sleep behaviors have progressively lower rates of early mortality. The investigators estimate that up to 8% of deaths from any cause could be linked to unfavorable sleep patterns.
“We observed a clear dose-response effect: the more healthy sleep behaviors a person has, the lower their risk of all-cause and cardiovascular death,” said Frank Qian, MD, an internal medicine resident at Beth Israel Deaconess Medical Center, a clinical fellow at Harvard Medical School, and a co-author of the study. “This suggests that simply logging enough hours isn’t enough. Restful sleep—falling and staying asleep with minimal difficulty—matters for long-term health.”
For the analysis, the team examined data from 172,321 adults (average age 50; 54% women) who completed the National Health Interview Survey between 2013 and 2018. Conducted annually by the Centers for Disease Control and Prevention and the National Center for Health Statistics, this survey assesses health behaviors across the U.S. population and includes questions about sleep patterns and sleep-related problems.
This is, to the authors’ knowledge, the first nationally representative study to evaluate how a combination of sleep behaviors—beyond sleep duration alone—relates to life expectancy and cause-specific mortality.
Participants in the study were about two-thirds White, 14.5% Hispanic, 12.6% Black, and 5.5% Asian. Investigators linked survey responses to National Death Index records through December 31, 2019, allowing analysis of the relationships between individual and combined sleep factors and mortality outcomes.
During a median follow-up of 4.3 years, 8,681 participants died. Of these deaths, 2,610 (30%) were attributed to cardiovascular disease, 2,052 (24%) to cancer, and 4,019 (46%) to other causes.
Researchers created a low-risk sleep score from five sleep-related factors assessed in the survey to measure sleep quality. Each factor was scored 0 or 1, yielding a maximum score of five points for the highest-quality sleep profile.
The five factors were: 1) sleeping seven to eight hours per night; 2) difficulty falling asleep no more than twice per week; 3) difficulty staying asleep no more than twice per week; 4) no use of sleep medication; and 5) feeling well rested at least five days per week.
“People who meet all five of these sleep measures tend to live longer,” Qian said. “Improving sleep and identifying sleep disorders could help prevent some premature deaths.”
The analysis adjusted for potential confounders, including socioeconomic status, tobacco and alcohol use, and existing medical conditions.
Compared with participants with zero to one favorable sleep factors, those with all five were 30% less likely to die from any cause, 21% less likely to die from cardiovascular disease, 19% less likely to die from cancer, and 40% less likely to die from other causes such as accidents, infections, or neurodegenerative conditions. The authors note that the exact contributors to the “other” category require further study.
Life expectancy differences were notable: individuals scoring a five had an estimated gain of 4.7 years for men and 2.4 years for women compared with participants who had none or only one favorable sleep element. The reasons for the larger gain observed in men remain unclear and warrant additional investigation.
Qian emphasized that cultivating healthy sleep habits early in life can pay long-term dividends. The present analysis modeled estimated life-expectancy gains beginning at age 30, though the same framework can be applied to older ages.
“Many health behaviors build over time,” he said. “Just as it’s never too late to start exercising or to stop smoking, it’s also important to address sleep early and routinely. Clinicians should ask about sleep during routine visits and include sleep assessment in overall health and disease management conversations.”
The investigators acknowledge limitations. Sleep measures were self-reported rather than objectively verified, and the survey did not capture details on the types, frequency, or duration of sleep medication use. Future research should clarify how the observed life-expectancy benefits evolve with aging and explore the sex differences seen in this analysis.
Prior studies have linked both short and long sleep duration to adverse cardiovascular outcomes, and sleep disorders such as obstructive sleep apnea are known to increase risks for high blood pressure, atrial fibrillation, and heart attack. This new analysis reinforces the importance of assessing multiple aspects of sleep quality—not just duration—when considering long-term health.
About this sleep research news
Author: Nicole Napoli
Source: American College of Cardiology
Contact: Nicole Napoli – American College of Cardiology
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Original Research: Findings presented at the American College of Cardiology’s Annual Scientific Session Together With the World Congress of Cardiology.