TOPLINE:

Nonrestorative sleep (NRS), defined as “feeling unrefreshed upon awakening that is not attributed to a lack of sleep,” was associated with a 14% increased adjusted risk for major adverse cardiac and cerebrovascular events (MACCEs) at 6 years, and a 26% higher risk in adults younger than 60 years, a new cohort study showed.

METHODOLOGY:

• Researchers in Japan retrospectively analyzed data of more than 86,000 participants (mean age, 51 years; 59% men) who underwent health checkups in 2014 and answered sleep-related questions for up to 6 years using health insurance claims and a health checkup database.
• Potential associations were examined between the status of NRS and risk for MACCEs, adjusting for covariates such as sleep apnea syndrome (SAS), allergic rhinitis, age, sex, BMI, lifestyle factors, and comorbidities.
• MACCEs were defined as events requiring hospitalization, including ischemic heart disease, heart failure, cerebral hemorrhage, and cerebral infarction.

TAKEAWAY:

• A history of cardiac and cerebrovascular diseases was associated with NRS (odds ratio [OR], 1.1; P = .005), hypertension (OR, 2.0; P < .001), diabetes (OR, 1.4; P < .001), SAS (OR, 1.96; P < .001), and allergic rhinitis (OR, 1.1; P < .001).
• After adjusting for covariates, NRS remained a significant risk factor for the development of MACCEs (adjusted hazard ratio [aHR], 1.14), especially among adults younger than 60 years (aHR, 1.26).
• NRS status was also associated with an increased risk for ischemic heart disease (aHR, 1.26) and heart failure (aHR, 1.26) but not cerebral hemorrhage (aHR, 0.95) or cerebral infarction (HR, 1.04).
• About 76% of participants with both MACCEs and newly diagnosed SAS during follow-up also had heart disease.

IN PRACTICE:

“NRS status is an important indicator of sleep hygiene, and improving NRS might reduce the risk of MACCE development,” the investigators wrote.

“Further screening tests (eg, home sleep apnea testing) and consequent appropriate treatment may reduce MACCE risk and maintain their health status in people with NRS identified during checkups,” they added.

SOURCE:

This study was led by Naomi Takahashi, Graduate School of Medicine, Kyoto University, Kyoto, Japan. It was published online on September 19 in Sleep.

LIMITATIONS:

The actual number of cases may have been underestimated. Additionally, the analysis could not adjust for participants’ sleep duration, and insomnia symptoms were not considered in the claims data.

DISCLOSURES:

This study was funded by the Japan Society for the Promotion of Science. Most of the investigators reported having financial ties with various sources outside the study. Full details are provided in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.