Sufficient Sleep Results in Possible Lower Risk of Heart Failure Among Adults

A recent survey of UK Biobank participants showed that healthy sleep habits were associated with a possible lower risk of heart failure among adults, even after adjusting for several confounders.

A recent survey of UK Biobank participants showed a possible 42% lower risk of heart failure among adults with advantageous sleep habits vs those with unhealthy sleep habits, even after adjusting for several confounders, reports the journal Circulation.

These confounders were diabetes, hypertension, medication use, genetic variations, and other covariates (HR, 0.87; 95% CI, 0.84-0.90).

“Our findings highlight the importance of improving overall sleep patterns to help prevent heart failure,” said Lu Qi, Md, PhD, corresponding author and professor of epidemiology and director of the Obesity Research Center at Tulane University in New Orleans, in a statement.

Overall, close to 1.3% (n = 5221) of the individuals developed heart failure within the 10-year follow-up period. However, they had a 42% lower risk of developing the condition and a lower chance overall if they met the following criteria:

  • Had healthy sleep habits
  • Were morning risers
  • Slept 7 to 8 hours each day
  • Had infrequent insomnia or snoring bouts
  • Avoided excessive daytime sleepiness (ie, unintentionally dozing or falling asleep)

The team of investigators looked at overall sleep patterns and quality, which encompassed sleep duration, insomnia and snoring, and other sleep-related features, which itself included 2 questions: (1) Is this participant an early bird or a night owl? and (2) Have they had instances of daytime sleepiness? Sleep duration comprised 3 measures: short (less than 7 hours/day), recommended (7-8 hours/day), and prolonged (9 or more hours/day)

Additional analyses revealed independent associations between lower risk of developing heart failure and the following:

  • Rising early (8% lower)
  • Sleeping 7 to 8 hours (12% lower)
  • Not having frequent insomnia (17% lower)
  • Not having daytime sleepiness (34% lower)

The observational study covered 408,802 participants with UK Biobank, which aims to better prevent, diagnose, and treat serious and life-threatening illnesses. These participants, ranging in age from 37 to 73 years, were recruited between 2006 and 2010 and followed for a median 10 years. Data were collected through April 1, 2019. Participants were excluded if they currently had heart failure or were missing information on their sleep behaviors at baseline. Heart failure was categorized based on International Classification of Diseases, Tenth Edition codes and nurse-reported data.

Sleep score was also determined by combining chronotype, sleep duration, insomnia, snoring and excessive daytime sleepiness. The higher the score, the healthier the sleep pattern. Overall, for every 1-point increase in healthy sleep score, the HR for heart failure was 0.85 (95% CI, 0.83-0.87).

Study limitations are that the sleep behaviors were self-reported (via touchscreen questionnaires), which could have introduced recall bias, and the follow-up period did not include evaluation on any possible changes in sleep behaviors. However, its strengths include the large sample size and prospective study design.

“Our results provide new evidence to indicate that adherence to the healthy sleep pattern is associated with a lower risk of heart failure, independent of the conventional risk factors,” the authors concluded. “Our findings highlight the potential importance of overall sleep behaviors in the prevention of heart failure.”


Li X, Xue Q, Wang M, et al. Adherence to a healthy sleep pattern and incident heart failure: a prospective study of 408802 UK Biobank participants. Circulation. Published online November 16, 2020. doi:10.1161/CIRCULATIONAHA.120.050792

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