Poor sleep in women linked to raised risk of heart disease

By Dr. Ananya Mandal, MDFeb 17 2020

Researchers from Columbia University Irving Medical Center have found that women who eat and sleep poorly are at a greater risk of getting obese, overweight, and heart disease. The study, published in the latest issue of the Journal of the American Heart Association, is titled, "Measures of Poor Sleep Quality Are Associated with Higher Energy Intake and Poor Diet Quality in a Diverse Sample of Women from the Go Red for Women Strategically Focused Research Network."

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The study was part of a population study called "Go Red for Women." The team of researchers explained that there had been several studies linking poor quality sleep and inadequate sleep with obesity, type 2 diabetes, heart disease, etc.

This new population study looked at each of the nutrients and sleep quality as well as sleep duration and its association with the heart and other health parameters. This is the most comprehensive look at the risk factors explained the researchers. They explained that sleep problems include several factors such as "ability to fall asleep and stay asleep," as well as "disordered patterns of sleep, such as insomnia." Earlier studies have looked at the connection between poor sleep and unhealthy diet but among men, middle-aged and elderly women alone.

This new study looked at a diverse population of women from a wide age range and different racial and ethnic minorities to see if the theory holds true for all women.

Brooke Aggarwal, assistant professor of medical sciences at Columbia University Vagelos College of Physicians and Surgeons and senior author of the study, explained, "Women are particularly prone to sleep disturbances across the life span because they often shoulder the responsibilities of caring for children and family and, later, because of menopausal hormones." For this study, the team looked at a diverse population of 495 women. These were had registered to participate in the "AHA Go Red for Women prospective cohort study," and were between the age of 20 and 76 years. Among the population, 61 percent belonged to racial and ethnic minorities while the others were white. To assess sleep quality and duration, the team used scales such as the "Pittsburgh Sleep Quality Index (PSQI)" and the "Insomnia Severity Index." Food habits were asked in detailed questionnaires, and for this, the team used the "Block Brief Food Frequency Questionnaire." This could assess both diet quantity and quality.

Results revealed that women who had higher PQSI scores meaning the poorer quality of sleep also had a higher weight of foot taken and higher sugar content of food and a lower intake of healthy unsaturated fats. This meant that poor sleep was associated with more inferior quality of food intake and thus could be associated with poorer health. Women who took longer to fall asleep – more than 60 minutes of sleep latency also took in more food by weight and energy content. They took lesser amounts of healthy whole grains when compared to women who took less than 15 minutes to fall asleep. Women who scored severe in insomnia ratings also ate more weight of food that was rich in energy and ate fewer amounts of unsaturated fats.

Aggarwal said, "Our interpretation is that women with poor-quality sleep could be overeating during subsequent meals and making more unhealthy food choices."

Faris Zuraikat, a postdoctoral fellow at Columbia University Vagelos College of Physicians and Surgeons and lead author of the study, added, "Poor sleep quality may lead to excessive food and calorie intake by stimulating hunger signals or suppressing signals of fullness. Fullness is largely affected by the weight or volume of food consumed, and it could be that women with insomnia consume a greater amount of food in an effort to feel full. However, it's also possible that poor diet has a negative impact on women's sleep quality." Zuraikat explained, "Eating more could also cause gastrointestinal discomfort, for instance, making it harder to fall asleep or remain asleep." Aggarwal also said, "Given that poor diet and overeating may lead to obesity--a well-established risk factor for heart disease--future studies should test whether therapies that improve sleep quality can promote cardiometabolic health in women."

The authors of the study wrote in conclusion, "Poor sleep quality was associated with greater food intake and lower‐quality diet, which can increase cardiovascular disease risk." They wrote that the clinical implications of these findings were that there should be "strategies to enhance sleep quality into behavioral interventions," in order to improve the efforts to improve the cardiovascular health among women.

The study was supported in part by the National Heart, Lung, and Blood Institute.