Sleep disturbance is associated with an increased risk of death, especially among women: A study

April 22, 2021 08:15 IST

Washington [US], April 22 (ANI): A new study has shown a clear link between the frequency and duration of unconscious wakefulness during sleep at night and an increased risk of dying from heart and blood vessel diseases, and death from any cause, especially in women .
The study’s findings were published in the European Heart Journal.
An 8001 study of men and women found that female adults who experienced most unconscious and longer periods of consciousness have almost double the risk of dying from cardiovascular disease during a follow-up of 6 to 11 years compared with the risk in the general population of women.
Society was less pronounced in men, and their risk of cardiovascular death increased by just over a quarter compared with the general male population.
Unconscious wrath, also known as cortical arousal, is a normal part of sleep. It occurs spontaneously and is part of the body’s ability to respond to potentially dangerous situations, such as obstructed noise or breathing. Pain, limb movements, trauma, temperature and light can also be triggers.
Dominik Linz, associate professor in the cardiology department at Maastricht University Medical Center (Netherlands), explains, “Obstructive sleep apnea is a common trigger for nocturnal seizures when breathing stops and the excitation system ensures activation of our body to change our sleeping position.and reopening the upper airway.Another cause of arousal may be ‘noise pollution’ at night through, for example, airborne noise at night. Depending on the strength of the armpit, one may become aware of the environment, but often it is not. Typically, people will feel tired and tired in the morning due to their sleep fragmentation but will not be aware of the individual disturbances. “
Previous research has shown that sleep duration, either too short or too long, is associated with increased mortality risks from cardiovascular or other causes. However, it is not yet known whether the burden of arousal (a combination of the number and duration of arousals) during a night’s sleep was also linked to the risk of death.
In collaboration between a team led by associate professor Mathias Baumert of the School of Electrical and Electronic Engineering at the University of Adelaide (Australia) and Professor Linz, researchers looked at data from sleep monitors worn by men and women participated in one of three studies: 2782 men in the Men’s Sleep Osteoporotic Fractures Study (MrOS), 424 women in the Osteoporotic Fractures Study (SOF), and 2221 men and 2574 women in the Sleep Heart Health Study ( SHHS). The average ages in the studies were 77, 83 or 64 years, respectively. Participants were followed over a period of several years, which ranged from six years (SOF) to an average of 11 years (MrOS).
After adjusting for factors that could affect the outcomes such as total sleep duration, age, medical history, body mass index (BMI) and smoking habits, the researchers found that women had a lower excitation burden than men. However, those with a burden of arousal accounting for more than 6.5 percent of their night’s sleep had a higher risk of dying from cardiovascular disease than women with a lower excitation burden: double the risk in SOF and 1.6 times the risk at SHHS. Their risk of dying from all causes was also increased 1.6 times in SOF and 1.2 times in SHHS.

Taking the women from the two studies together, those with an excitation burden of more than 6.5 percent had a 12.8 percent risk of dying from cardiovascular disease, almost double the risk of women of a similar age in the population overall with a risk of 6.7 per cent. The risk of dying from any cause was 21 per cent among women in the general population, which increased to 31.5 per cent among women in both studies with an excitation burden of more than 6.5 per cent
Men with a burden of arousal accounting for more than 8.5 percent of their night’s sleep had a 1.3 times greater risk of dying from cardiovascular disease (MrOS) or any cause (SHHS), compared to men with lower arousal burdens, but findings for an increased risk of death from any cause in MrOS or cardiovascular disease in SHHS were not statistically significant.
When the researchers looked at all men in both studies, those with an excitation burden of more than 8.5 percent had a 13.4 percent risk and 33.7 percent death from cardiovascular disease or any cause, respectively, of ‘compared with the risk in the general population of men of a similar age of 9.6 per cent and 28 per cent, respectively.
Professor Linz said, “It is not clear why there is a difference between men and women in the societies, but there are some possible explanations. The triggers that cause arousal or the body’s response to arousal may be different in women compared This may explain the relatively higher risk of cardiovascular death in women. Women and men may have different compensatory mechanisms for coping with the detrimental effects of arousal .. Women may have a higher arousal threshold and thus may have a higher trigger burden in women compared to men. “
He said older age, BMI and severity of sleep apnea increase burdens of excitement. “Although age cannot be changed, BMI and sleep apnea can be adjusted and can be an interesting target to reduce the burdens of excitement. Whether this translates to lower risks of dying from cardiovascular disease deserves further study. For me as a doctor , high arousal the burden helps identify patients who may be at greater risk of cardiovascular disease We need to advise our patients to take care of their sleep and practice good sleep ‘hygiene’ Measures to reduce noise pollution at night, lose weight and treat sleep apnea. it may also help reduce the burden of excitement. “
Professor Baumert said, “In order to incorporate the assessment of the burdens of excitation into routine strategies for reducing the risk of cardiovascular disease, we need affordable, accessible and highly accessible techniques to estimate sleep duration and fragmentation and to detect wearable device arousals measuring activity and changes in breathing patterns provide important information. “
Limitations of the study include that it was conducted in predominantly older, white people and therefore its findings cannot be extrapolated to other races than younger men and women. The researchers did not consider the potential impact of medicines; participants’ sleep monitoring was done on one night and therefore does not consider night-to-night variations. Finally, it can only show that the burden of increased sleep arousal is associated with a higher risk of death, not that sleep disturbances cause the increased risk.
In an accompanying editorial, Professor Borja Ibanez, director of clinical research at the Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid (Spain), and colleagues, who were not involved in the research, write that the strength of the study is that the excitation burden is measured objectively with sleep monitors, rather than being self-reported by participants. They point out that disruption of the body’s natural circadian rhythm is known to be associated with the development of often undetected fat accumulation in arteries and may be a potential mechanism for increasing the risk of cardiovascular problems.
They continued, “Although there are many gaps in knowledge about the relationship between sleep and CVD [cardiovascular disease] still being studied in the coming years, this study provides solid evidence that supports the importance of sleep quality for improved CV health. Further evidence combining comprehensive sleep evaluation with biological sampling and long-term follow-up will be desirable. . . What remains to be determined is whether an intervention aimed at improving sleep quality can reduce the incidence of CVs and deaths. While waiting for these trials, we wish you sweet dreams. “(ANI)