Add Sleep to Your Healthy Habit Checklist

Sufficient sleep reduced heart disease risk when combined with other healthy habits

/ Author:  / Reviewed by: Chris Galloway, M.D.

(RxWiki News) It seems pretty straightforward: the more healthy behaviors you practice, the less likely you are to develop heart disease. But did you know that sleep plays a role too?

A recent study found that getting at least seven hours of sleep each night may lower heart disease risk even further when you are practicing other healthy habits.

These other healthy habits include regular physical activity, a healthy diet, not smoking and moderate alcohol consumption.

Those who got enough sleep and followed these healthy habits reduced their heart disease risk compared to those with only one of these habits.

"Get at least 7 hours of sleep each night."

The study, led by Marieke P. Hoevenaar-Blom, of the National Institute for Public Health and the Environment in the Netherlands, looked at whether getting enough sleep reduced individuals' risk of cardiovascular disease if they had other healthy behaviors.

The researchers followed 6,672 men and 7,967 women, all aged 20 to 65, who did not have cardiovascular disease when the study began.

The researchers gathered data on the participants' health habits from 1994 to 1997 through a series of questionnaires.

The researchers were specifically looking for individuals who met several benchmarks for healthy behaviors:

  • Getting sufficient physical activity, defined as at least 3.5 hours a week of cycling or sports
  • Eating a healthy diet, defined as having a score of at least 5 on the "Mediterranean Diet Score"
  • Consuming alcohol moderately
  • Not smoking
  • Getting at least seven hours of sleep each night

The participants were followed for an average of 10 to 14 years. During this time, the participants experienced a total of 607 cardiovascular events, including heart attacks and strokes. A total of 129 of these incidents were fatal.

The researchers calculated both the participants' risk of having a cardiovascular event and of dying from one based on the number of healthy factors they had.

Those who met four of the healthy behaviors listed above had a 57 percent lower chance of having any kind of cardiovascular event than those who only had one (or none) of the healthy behaviors.

Those who incorporated at least four of these healthy factors into their lives, compared to those with one or none, had a 67 percent lower risk of dying from a cardiovascular event such as a heart attack or stroke.

Then the researchers considered participants' risk when getting enough sleep was included in addition to four of the other healthy behaviors.

Getting sufficient sleep in addition to following four other healthy behaviors resulted in a 65 percent lower risk of any cardiovascular event compared to those meeting one or none of the healthy behaviors.

Those getting enough sleep and meeting the requirements for four other healthy factors had an 83 percent lower risk of dying from a heart attack or stroke.

"Sufficient sleep and adherence to all four traditional healthy lifestyle factors was associated with lower cardiovascular disease risk," the authors wrote.

"When sufficient sleep duration was added to the traditional lifestyle factors, the risk of cardiovascular disease was further reduced," the authors wrote.

Sarah Samaan, MD, a cardiologist with Legacy Heart Center in Dallas-Fort Worth and a dailyRx expert, said this study is fascinating.

"Sleep is still something of a mystery, but studies over the past decade have linked poor sleep quality and lack of sufficient sleep to a diverse range of health conditions including diabetes, high blood pressure, depression and obesity," Dr. Samaan said. "This study shows us that lack of sleep appears to be an important risk factor for heart disease and stroke."

Dr. Samaan recalled frequently hearing the adage "You can sleep when you're dead" while in medical school.

"It now appears that insufficient sleep can in fact hasten one's death," she said.

But what is especially noteworthy in the study is the positive impact a person can have on their cardiovascular risk by choosing to have healthy habits.

"Other studies have reported similar reductions in heart attack and stroke risk by making simple choices to exercise regularly, eat a Mediterranean diet, drink alcohol in moderation and avoid tobacco," Dr. Samaan said.

"Imagine the number of lives saved, the disabilities avoided, the cost of pharmaceuticals avoided and the money put to better use if more people would follow these straightforward guidelines," she said.

This study was published July 3 in the European Journal of Preventive Cardiology.

The research was funded by the Ministry of Health, Welfare and Sport for the Netherlands and the National Institute for Public Health and the Environment. The authors declared no conflicts of interest.

Reviewed by: 
Review Date: 
July 3, 2013
Last Updated:
July 18, 2013