Good sleep 'essential' for cardiovascular health, American Heart Association says

Getting enough sleep is important for a number of reasons. It can prevent illness, it can help maintain a healthy weight, and it can improve your mood.

And for those looking for yet another reason to get a good night’s rest: It can also keep your heart healthy, according to the American Heart Association (AHA). 

The U.S. nonprofit added sleep duration to its list of components for cardiovascular health. The checklist, called "Life’s Essential 8," was updated from the previous "Life’s Simple 7" list first published in 2010. The new advisory was also published Wednesday in Circulation, the association’s peer-reviewed journal. 

Sleep, as well as a healthy diet, participation in physical activity, avoidance of nicotine, healthy weight, and healthy levels of blood lipids, blood glucose, and blood pressure, round out the eight "essential" categories for optimal heart health. 

Heart disease is the leading cause of death in the United States.

"The new metric of sleep duration reflects the latest research findings: sleep impacts overall health, and people who have healthier sleep patterns manage health factors such as weight, blood pressure or risk for Type 2 diabetes more effectively," said American Heart Association President Donald M. Lloyd-Jones, M.D., Sc.M., FAHA, who led the advisory writing group. 

"In addition, advances in ways to measure sleep, such as with wearable devices, now offer people the ability to reliably and routinely monitor their sleep habits at home," Lloyd-Jones added.

Many Americans have trouble falling, staying asleep

A 2020 survey of U.S. adults conducted found that 14.5% of Americans had trouble falling asleep most days or every day over the previous 30 days, according to the findings published this month by the U.S. Centers for Disease Control and Prevention. 

The percentage of adults who had trouble falling asleep increased as education level and family income decreased. Sleep issues also increased as the place of residence became more rural, according to the findings. 

A lower family income and more rural residence were also linked to a higher likelihood of trouble staying asleep at night, according to the findings.

More non-Hispanic White (21.0%) adults had trouble staying asleep most days or every day in the past 30 days, compared with non-Hispanic Black (15.4%), Hispanic (10.6%), and non-Hispanic Asian (8.7%) adults. 

More women (17.1%) had trouble falling asleep, compared to men (11.7%), and 20.7% of women surveyed said they had trouble staying asleep, compared to 14.7% of men. 

How much sleep is needed for optimal heart health?

The new sleep metric suggests 7 to 9 hours of sleep daily for optimal cardiovascular health for adults, and more for children depending on their age.

Ideal daily sleep ranges for children are between 10 and 16 hours per 24 hours for ages 5 and younger. Ages 6 to 12 are recommended to get between 9 and 12 hours of sleep, while those between 13 and 18 are suggested to get 8 to 10 hours.

What else constitutes healthy sleep?

In its updated guidance, the association says much of the existing research has focused on sleep duration but notes that sleep health is "multidimensional." Timing, regularity, efficiency, satisfaction, and impact on daytime alertness also play a role. 

Keeping a consistent sleep schedule, including getting up at the same time every day, can help build good sleep habits, according to the American Academy of Sleep Medicine. Setting a bedtime that is early enough to get at least 7 to 8 hours of sleep for adults is also key.

Other tips include keeping a comfortable and cool bedroom environment, limiting exposure to bright light and electronic devices at bedtime, and avoiding alcohol and caffeine before bedtime.

"Your daily routines – what you eat and drink, the medications you take, how you schedule your days and how you choose to spend your evenings – can significantly impact your quality of sleep," the AASM states on its website. "Even a few slight adjustments can, in some cases, mean the difference between sound sleep and a restless night."

Diet, nicotine exposure among updates

Diet, nicotine exposure, blood lipids, and blood glucose all received updates on the AHA’s new checklist. 

The association has developed a new way to assess how well adults and children are eating, as well as at an overall population level. This includes a 16-item questionnaire about the weekly frequency of eating olive oil, vegetables, berries, meat, fish, dairy, grains, and more.

Nicotine exposure previously only centered on traditional cigarettes and has been amended to include e-cigarettes, vaping devices, and exposure to second-hand smoke for children and adults. 

The metric for blood lipids — cholesterol and triglycerides — was updated to use non-HDL cholesterol as the preferred number to monitor, rather than total cholesterol. 

HDL is the "good" cholesterol, the AHA said in a statement. Other forms of cholesterol, when high, are linked to cardiovascular disease risk. 

The new shift was made because non-HDL cholesterol can be measured without fasting beforehand, thereby increasing its availability at any time of day and implementation at more appointments, the AHA said.

Measuring blood glucose levels expanded to include hemoglobin A1c readings, which measure a patient’s blood sugar levels over the previous three months, according to the CDC. This test is commonly used to diagnose pre-diabetes and diabetes. 

The AHA said hemoglobin A1c can better reflect long-term glycemic control.

This story was reported from Cincinnati.