Study links late bedtimes to higher heart disease risk

By Sola Ogundipe

People who naturally stay up late may be putting their hearts under added strain as they age.

A large study tracking more than 300,000 adults found that middle-aged and older night owls had poorer overall heart health and a higher risk of heart attack and stroke than those who were active earlier in the day, with the effect especially pronounced in women.

Much of this elevated risk appeared to stem from lifestyle factors common among evening types, including smoking and inadequate sleep.

Adults in midlife and older age who tend to be most active in the evening, especially women, showed poorer overall heart health than those without a strong preference for mornings or evenings, based on research.

Common habits among night owls, including lower-quality diets, too little sleep, and higher rates of smoking, that help explain why their cardiovascular health scores were lower.

Researchers say the findings point to a clear opportunity, since improving daily habits such as sleep, diet, and smoking cessation could help night owls reduce their risk of heart attack and stroke.

Adults in middle age and later life who tend to be more active in the evening were found to have worse cardiovascular health than those who are active earlier in the day.

The association appeared to be stronger among women, according to the new research published in the Journal of the American Heart Association, an open-access, peer-reviewed journal of the American Heart Association.

The findings suggest that when people are most active during the day may play an important role in long-term heart health.

Researchers examined health data from more than 300,000 adults (average age of about 57 years) enrolled in the UK Biobank. The analysis focused on chronotypes, which describe a person’s natural preference for sleep and wake timing, and how those preferences relate to cardiovascular health.

Participants were grouped based on their self-identified daily patterns. About 8 percent described themselves as “definitely evening people,” meaning they typically went to bed very late (up till 2 a.m.) and reached peak activity later in the day.

Around 24 percent reported being “definitely morning people,” who tended to wake up earlier, go to bed earlier (for example 9 p.m.), and be most active earlier in the day.

The remaining 67 percent were categorised as having an “intermediate” chronotype if they were unsure or said they were neither clearly a morning nor evening person.

Cardiovascular health looks at behaviours and health factors known to support heart health, including eating a healthy diet, staying physically active, not smoking, and getting good-quality sleep. It also includes maintaining healthy levels of body weight, cholesterol, blood sugar, and blood pressure.

The researchers identified several notable patterns when comparing chronotype groups: Compared with people in the intermediate category, those classified as “evening people,” often called night owls, were 79 percent more likely to have an overall poor cardiovascular health score.

Night owls also had a 16 percent higher risk of experiencing a heart attack or stroke during a median follow-up period of about 14 years.

The link between evening chronotype and lower heart health scores was stronger among women than among men.

Much of the increased heart disease risk seen in evening types were linked to lifestyle habits, particularly nicotine use and insufficient sleep.

In contrast, “morning people,” also known as early birds, showed a 5 percent lower prevalence of poor cardiovascular health scores compared with individuals without a strong morning or evening preference.

“‘Evening people’ often experience circadian misalignment, meaning their internal body clock may not match the natural day-to-night light cycle or their typical daily schedules,” said lead study author Sina Kianersi, a research fellow in the division of sleep and circadian disorders at Brigham and Women’s Hospital and Harvard Medical School, both in Boston.

“Evening people may be more likely to have behaviors that can affect cardiovascular health, such as poorer diet quality, smoking and inadequate or irregular sleep.

“These findings show that the higher heart disease risks among evening types are partly due to modifiable behaviors such as smoking and sleep. Therefore, evening types have options to improve their cardiovascular health. Evening types aren’t inherently less healthy, but they face challenges that make it particularly important for them to maintain a healthy lifestyle.”

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