Does poor sleep increase the risk of negative health outcomes?




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    Sleep plays an important role in overall health. Not getting enough sleep, or not getting enough good-quality sleep, is associated with a higher risk of many negative health outcomes. The following are just some of the outcomes linked to poor sleep:

    • Coronary heart disease. Sleeping less than 7 hours per night is associated with a higher risk of coronary heart disease (CHD) and an elevated risk of cardiovascular disease (CVD) mortality.[1][2] Additionally, a genetic study found that a short sleep duration (6 or fewer hours per night) appeared causally related to a higher risk of CHD, high blood pressure, and heart attack.[3]

    • Obesity: Getting less sleep is associated with a higher risk of obesity.[4][5] Consistent with this association, restricting sleep to just 4 hours per night has been shown to increase hunger and calorie intake and lead to weight gain (sometimes in as little as 5 days).[6][7] Conversely, increasing sleep time from 5.9 to 7.1 hours per night in one clinical trial led to a reduction in caloric intake and a loss of body fat after 2 weeks.[8]

    • Alzheimer’s disease: Poor quality sleep and sleep problems are associated with a higher risk of Alzheimer’s disease, and a short sleep duration is linked to a faster rate of cognitive decline.[9][10] This could be related to the glymphatic system, a biological drainage system active during sleep that seems to clear the brain of beta amyloid, a protein linked to Alzheimer’s disease.[11][12]

    • Type 2 diabetes: A meta-analysis of roughly one million people found that a short sleep duration(6 or fewer hours per night) was associated with an increase in the risk of type 2 diabetes.[13] Additionally, a genetic study found that insomnia increased the risk of type 2 diabetes, suggesting a causal association between sleep problems and diabetes.[14]

    • Bone fracture: Sleep disturbances, insomnia, and a short sleep duration (less than 7 hours per night) are associated with a higher risk of breaking a bone, possibly by increasing the tendency to fall.[15][16][17] A relationship between poor sleep, bone fractures, and low bone mineral density has also been observed in genetic studies.[16][18]

    • Depression: A short sleep duration (7 or fewer hours per night) is associated with a greater risk of depression. Having insomnia is also associated with a higher risk of developing depression[19] and treating insomnia has been shown to improve symptoms of depression.[20][21][22]

    Health outcomes linked to poor sleep



    1. ^Dongming Wang, Wenzhen Li, Xiuqing Cui, Yidi Meng, Min Zhou, Lili Xiao, Jixuan Ma, Guilin Yi, Weihong ChenSleep duration and risk of coronary heart disease: A systematic review and meta-analysis of prospective cohort studiesInt J Cardiol.(2016 Sep 15)
    2. ^Krittanawong C, Tunhasiriwet A, Wang Z, Zhang H, Farrell AM, Chirapongsathorn S, Sun T, Kitai T, Argulian EAssociation between short and long sleep durations and cardiovascular outcomes: a systematic review and meta-analysis.Eur Heart J Acute Cardiovasc Care.(2019-Dec)
    3. ^Sizhi Ai, Jihui Zhang, Guoan Zhao, Ningjian Wang, Guohua Li, Hon-Cheong So, Yaping Liu, Steven Wai-Ho Chau, Jie Chen, Xiao Tan, Fujun Jia, Xiangdong Tang, Jie Shi, Lin Lu, Yun-Kwok WingCausal associations of short and long sleep durations with 12 cardiovascular diseases: linear and nonlinear Mendelian randomization analyses in UK BiobankEur Heart J.(2021 Sep 7)
    4. ^Qionggui Zhou, Ming Zhang, Dongsheng HuDose-response association between sleep duration and obesity risk: a systematic review and meta-analysis of prospective cohort studiesSleep Breath.(2019 Dec)
    5. ^Francesco P Cappuccio, Frances M Taggart, Ngianga-Bakwin Kandala, Andrew Currie, Ed Peile, Saverio Stranges, Michelle A MillerMeta-analysis of short sleep duration and obesity in children and adultsSleep.(2008 May)
    6. ^Naima Covassin, Prachi Singh, Shelly K McCrady-Spitzer, Erik K St Louis, Andrew D Calvin, James A Levine, Virend K SomersEffects of Experimental Sleep Restriction on Energy Intake, Energy Expenditure, and Visceral ObesityJ Am Coll Cardiol.(2022 Apr 5)
    7. ^Bingqian Zhu, Changgui Shi, Chang G Park, Xiangxiang Zhao, Sirimon ReutrakulEffects of sleep restriction on metabolism-related parameters in healthy adults: A comprehensive review and meta-analysis of randomized controlled trialsSleep Med Rev.(2019 Jun)
    8. ^Esra Tasali, Kristen Wroblewski, Eva Kahn, Jennifer Kilkus, Dale A SchoellerEffect of Sleep Extension on Objectively Assessed Energy Intake Among Adults With Overweight in Real-life Settings: A Randomized Clinical TrialJAMA Intern Med.(2022 Feb 7)
    9. ^Omonigho M Bubu, Michael Brannick, James Mortimer, Ogie Umasabor-Bubu, Yuri V Sebastião, Yi Wen, Skai Schwartz, Amy R Borenstein, Yougui Wu, David Morgan, William M AndersonSleep, Cognitive impairment, and Alzheimer's disease: A Systematic Review and Meta-AnalysisSleep.(2017 Jan 1)
    10. ^Ma Y, Liang L, Zheng F, Shi L, Zhong B, Xie WAssociation Between Sleep Duration and Cognitive Decline.JAMA Netw Open.(2020-09-01)
    11. ^Jeffrey J Iliff, Minghuan Wang, Yonghong Liao, Benjamin A Plogg, Weiguo Peng, Georg A Gundersen, Helene Benveniste, G Edward Vates, Rashid Deane, Steven A Goldman, Erlend A Nagelhus, Maiken NedergaardA paravascular pathway facilitates CSF flow through the brain parenchyma and the clearance of interstitial solutes, including amyloid βSci Transl Med.(2012 Aug 15)
    12. ^Xie L, Kang H, Xu Q, Chen MJ, Liao Y, Thiyagarajan M, O'Donnell J, Christensen DJ, Nicholson C, Iliff JJ, Takano T, Deane R, Nedergaard MSleep drives metabolite clearance from the adult brainScience.(2013 Oct 18)
    13. ^Anothaisintawee T, Reutrakul S, Van Cauter E, Thakkinstian ASleep disturbances compared to traditional risk factors for diabetes development: Systematic review and meta-analysis.Sleep Med Rev.(2016-12)
    14. ^Xue Gao, Heli Sun, Yu Zhang, Long Liu, Juping Wang, Tong WangInvestigating Causal Relations Between Sleep-Related Traits and Risk of Type 2 Diabetes Mellitus: A Mendelian Randomization StudyFront Genet.(2020 Dec 15)
    15. ^Feng Pan, Jing Tian, Flavia Cicuttini, Graeme JonesSleep disturbance and bone mineral density, risk of falls and fracture: Results from a 10.7-year prospective cohort studyBone.(2021 Jun)
    16. ^Yu Qian, Jiangwei Xia, Ke-Qi Liu, Lin Xu, Shu-Yang Xie, Guo-Bo Chen, Pei-Kuan Cong, Saber Khederzadeh, Hou-Feng ZhengObservational and genetic evidence highlight the association of human sleep behaviors with the incidence of fractureCommun Biol.(2021 Nov 26)
    17. ^Jane A Cauley, Kathleen M Hovey, Katie L Stone, Chris A Andrews, Kamil E Barbour, Lauren Hale, Rebecca D Jackson, Karen C Johnson, Erin S LeBlanc, Wenjun Li, Oleg Zaslavsky, Heather Ochs-Balcom, Jean Wactawski-Wende, Carolyn J CrandallCharacteristics of Self-Reported Sleep and the Risk of Falls and Fractures: The Women's Health Initiative (WHI)J Bone Miner Res.(2019 Mar)
    18. ^Chen J, Zhang J, So HC, Ai S, Wang N, Tan X, Wing YKAssociation of Sleep Traits and Heel Bone Mineral Density: Observational and Mendelian Randomization Studies.J Bone Miner Res.(2021-11)
    19. ^Liqing Li, Chunmei Wu, Yong Gan, Xianguo Qu, Zuxun LuInsomnia and the risk of depression: a meta-analysis of prospective cohort studiesBMC Psychiatry.(2016 Nov 5)
    20. ^W Vaughn McCall, Jill N Blocker, Ralph D'Agostino Jr, James Kimball, Niki Boggs, Barbara Lasater, Roger Haskett, Andrew Krystal, William M McDonald, Peter B RosenquistTreatment of insomnia in depressed insomniacs: effects on health-related quality of life, objective and self-reported sleep, and depressionJ Clin Sleep Med.(2010 Aug 15)
    21. ^Maurizio Fava, W Vaughn McCall, Andrew Krystal, Thomas Wessel, Robert Rubens, Judy Caron, David Amato, Thomas RothEszopiclone co-administered with fluoxetine in patients with insomnia coexisting with major depressive disorderBiol Psychiatry.(2006 Jun 1)
    22. ^Rachel Manber, Jack D Edinger, Jenna L Gress, Melanie G San Pedro-Salcedo, Tracy F Kuo, Tasha KalistaCognitive behavioral therapy for insomnia enhances depression outcome in patients with comorbid major depressive disorder and insomniaSleep.(2008 Apr)