Research & Education

Impact of Weekday Sleep Debt on Women’s Cardiovascular Health

In an ideal world, there wouldn’t be as many daily demands or as much pressure and competition as there is nowadays. Oftentimes, these demands lead to increased stress, anxiety and burnout. In today’s modern industrialized society, it’s considered the norm to have a never-ending to-do list, and it’s a burden to always have to achieve or complete more things, whether it’s for our careers or for our personal lives. Yet, the more we do, the less sleep we get, which is a heavy price to pay considering that sleep (or the lack thereof) plays a vital role in our overall health. 

Heavily caffeinating upon waking and again between 1:00 p.m. and 3:00 p.m. to try to avoid that mid-afternoon crash has become routine for many Americans. This can often lead to feeling “wired and tired,” where it becomes difficult to fall asleep at bedtime, even though we’re exhausted. Chronic sleep deprivation is plaguing Americans, especially health-care workers, such as nurses and physicians. Chronic sleep deprivation is a critical factor in the development of many chronic conditions. According to research, nearly one-third of Americans wake up feeling fatigued every day due to inadequate sleep or less than 7 hours of sleep per night.

According to a follow-up cohort study published in the journal Sleep by the Sleep Research Society®, “sleep debt,” which is sleep deficiency during the week compared to the weekend, is associated with poorer ideal cardiovascular health (ICH) in older women. Previous research also confirms the indication for increased risk of cardiovascular disease with inadequate sleep duration and quality. Furthermore, according to a recent cross-sectional evaluation of the National Health and Nutrition Examination Survey published in 2020, less than 6 hours of sleep or more than 9 hours was linked to significantly reduced odds of ICH, and this was only with 21.3% of the population being analyzed who had ICH. In the current study, “sleep debt is defined as the difference between self-reported total weekday and weekend sleep hours of at least 2 hours” (i.e., a 2-hour sleep discrepancy during the week compared to the weekend). 

Researchers investigated and analyzed data from more than 22,000 older female health professionals (on average, aged 72 years) who participated in the Women’s Health Stress Study. The ideal cardiovascular health parameters in the study were body mass index, smoking, diet, blood pressure, physical activity, total cholesterol and glucose levels defined by the strategic 2020 goals from the American Heart Association. The results showed that women with sleep debt were significantly more likely to have hypertension and to be obese compared with women who did not have sleep debt. Even after adjusting for age and race, education, income, depression/anxiety, cumulative psychosocial stress and snoring, the relationship between poorer ICH and sleep debt was significant. This confirms previous findings that show circadian rhythm disruptions have a negative impact on health.

In a previous article, we discussed how chronic sleep debt is associated with the development of obesity, metabolic syndrome and other related chronic health conditions, and how patients who were struggling to lose weight prioritized sleep for stubborn fat loss. Even teenagers who get less than 6 hours of sleep are more likely to become obese later in life. A study examining participants who did not have weekday sleep debt with those patients who had early Type 2 Diabetes demonstrated that those with sleep debt were “72% more likely to be obese,” and that risk of insulin resistance and obesity increased by 41% and 18%, respectively, for every 30 minutes of sleep deprivation. These results suggest that the long-term metabolic disturbances caused by inadequate sleep may also foster the progression of diabetes.

We put a lot of focus on healthy diets, quality supplements, exercise and other aspects of promoting a healthy lifestyle, but these are all negated if we ignore our fundamental need for appropriate quality and quantity of sleep to the point that we risk developing chronic diseases. This isn’t to say your patients shouldn’t be mindful of their diets, daily movement and dietary supplements, but sleep may need to be the first priority when it comes to maintaining wellness and reducing the risk of developing a cardiometabolic disease and/or other chronic conditions. For further sleep support, patients may consider supplementing with 5-HTP, melatonin, L-theanine or magnesium, which all promote restful sleep.