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Regular Sleep, Physical Activity Can Benefit Heart Health in Middle Age

  • New research found that irregular sleep patterns are associated with poorer cardiovascular health in middle-aged people.
  • Physical activity may help counteract that negative correlation, researchers found.
  • Experts recommend prioritizing both healthy sleep habits and physical exercise for the sake of heart health.

Irregular sleep patterns can negatively affect heart health, but physical activity can minimize that correlation, a new study finds.


The new research, published last month in the Journal of Activity, Sedentary and Sleep Behaviors, found that an irregular sleep pattern is associated with poorer cardiovascular health for middle-aged adults.


In particular, poor sleep may lead to a larger waist circumference and poorer readings on blood sugar levels, triglyceride levels, and blood pressure, which increase cardiovascular disease risk.


“This is the first large-scale population study focusing on middle-aged people that used an activity monitor to measure physical activity and sleep rhythm,” Laura Nauha, MSc, one of the study authors and a doctoral researcher in the Faculty of Medicine, University of Oulu told Health.


The study used data from lifestyle questionnaires of about 3700 participants. Researchers also measured participants’ blood pressure, blood lipid values, and glucose tolerance. Participants’ physical activity and sleep rhythm were measured using an activity meter.


Researchers discovered that participants with irregularities in bedtime, wake-up time, and time in bed had less desirable cardiometabolic health markers, such as higher body mass index, higher blood pressure, and higher glucose levels than those with more stable sleep patterns.


What’s more, the researchers found that physical activity offset some of the risks to the heart when sleep patterns are poor.


Here’s why poor sleep habits can lead to poor heart health, how physical activity may help offset that effect, and how to promote a healthy sleeping routine in middle age.


Middle age woman sleeping

Getty Images / miniseries


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Why Does Poor Sleep Lead to Poor Heart Health?

Irregular sleep can cause a host of issues, including trouble concentrating, poor moods, a weakened immune system, weight gain, and stress, Raj Dasgupta, MD, FACP, FCCP, FAASM, a quadruple board-certified physician and chief medical advisor for Pillar4 told Health.


Even worse, irregular sleep habits can wreak havoc on your heart.


A 2023 study found that irregular sleeping patterns could increase your risk of developing cardiovascular disease.


Another study found that those who have trouble falling asleep, wake up in the middle of the night, or sleep less than six hours at night, may have nearly triple the risk of heart disease.


“For people in the middle-aged bracket, irregular or poor sleep also can disrupt the body’s circadian rhythm, spark inflammation, and throw important hormones off balance,” Dasgupta said. “This disruption can cause increased blood pressure and put a strain on the heart over time.”


Nauha explained that poor sleep quality might contribute to sedentary behavior and unhealthy dietary habits, consequently heightening the risk of cardiovascular diseases.


Another potential explanation for the connection between irregular sleep and poor heart health is the dysfunction in the autonomic nervous system that poor sleep causes, Scott Kutscher, MD, clinical associate professor of Psychiatry and Behavioral Sciences—Sleep Medicine, Stanford University School of Medicine told Health.


“Sleep is a state of high parasympathetic activity (the rest and digest state, when blood pressure and heart rate are both low),” he said. “But when sleep becomes irregular, it can lead to higher amounts of sympathetic activity (our fight or flight state, when blood pressure and heart rate are high).”


When irregular sleep patterns persist, this can cause the flight or fight state to become more dominant. When this happens, it can lead to persistently high blood pressure, elevated heart rates, and cardiovascular disease, Kutscher explained.


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What Is It About Physical Activity That Offsets the Risks of Irregular Sleep?

Although this study did not pinpoint exactly why physical activity can offset the risks, the research suggests physical activity might weaken the harmful associations between an irregular sleep rhythm and cardiometabolic risk factors.


Some of this may have to do with the simple fact that exercise is good for the heart.


Not only does exercise improve blood flow and lung function, but it also reduces the risk of heart attack. It can even promote weight loss, reduce glucose levels, and lower blood pressure.


“Physical activity is one of the single best things any person can do to protect their heart in general, but it also can specifically improve sleep quality directly,” Matthew Goldstein, MD, FACC, FHRS, a cardiologist at Cardiology Consultants of Philadelphia, told Health.


For instance, exercise can help establish sleep-wake rhythms and can promote deeper, less disrupted sleep.


Research has shown that regular physical activity can lower stress and anxiety, allowing a person to relax and sleep better. It also can be a cure for insomnia and may help people get better quality sleep.


“Physical activity and sleep go hand in hand,” said Brooke Aggarwal, EdD, MS, FAHA, an assistant professor of medical sciences in the division of cardiology, department of medicine, Columbia University Medical Center, and an American Heart Association Go Red for Women volunteer expert.


“When we sleep well at night, we feel more refreshed and energetic and are likely to be more active during the day,” she explained. “Moderate to intense exercise during the daytime, but not too close to bedtime, helps us to fall asleep faster and to rest more deeply and soundly at night.”


How to Promote Better Sleep In Middle Age

Exercising is great for your heart health and your sleep patterns, but it doesn’t provide an excuse to ignore poor sleep habits and not prioritize sleep, Dasgupta clarified.


“Good sleep habits, like having a regular bedtime and creating a comfortable, dark, cool sleep environment, are still very important,” he said. “Exercise helps, but it’s best to do both to keep yourself healthy and well-rested.”


For a good sleep routine, Dasgupta suggests going to bed and waking up consistently at the same time every night. He also suggests:


  • Leading up to bedtime with calming activities like reading or enjoying a warm bath
  • Making your bedroom comfortable, dark, quiet, and cool
  • Avoiding blue light exposure by limiting screens like phones and tablets before sleeping
  • Relaxing with techniques like deep breathing or mindfulness
  • Limiting naps, especially after around 2 PM, and keeping them to around 15 to 20 minutes

You also should get as much exposure as possible to sunlight during the day.


“In addition to physical activity, our sleep-wake rhythms respond to light. Light during the day—especially on waking up—and avoiding light at night can help keep our sleep healthy,” Kutscher said.


Also, keep in mind that exercise alone is not enough to maintain optimal health over time.


“Proper diet and proper sleep are critical,” Kutscher said. “I often tell my patients to think about their sleep now for the sake of their heart 20 years from now.”


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