In 2010, the American Heart Association (AHA) identified seven healthy habits and health metrics that they called Life’s Simple 7 to assess people’s cardiovascular health. The checklist included prompts to reduce sugar, get moving, eat better, stop smoking, optimize blood pressure, and lower total cholesterol — the usual suspects.
Now, 10 years later, armed with a robust body of research, including a 2020 study on the role of sleep as a cardiovascular health metric, the American Heart Association has added another measurement to their list of essential components for optimal heart health: sleep.
Just last week, the American Heart Association announced that they were rebranding Life’s Simple 7 as Life’s Essential 8. While there were updates made to the guidelines for diet, cholesterol, and blood sugar, it looks like the American Heart Association took that 2020 study to heart (pun intended), adding sleep duration.
The link between sleep and heart health
Research has shown that poor sleep — as well as sleeping either too much or too little — is associated with coronary heart disease along with poor psychological health, says Dr. Jonathan Fisher, clinical cardiologist and certified mindfulness meditation teacher. Sleep is also an essential foundational block for other components of the AHA’s list. According to Fisher, “When you’re sleep deprived, you increase your risk of developing conditions that can lead to or worsen heart disease.”
For instance, sleep plays an important role in blood-sugar regulation. “Studies show that sleep disturbances (irregular sleep, not sleeping enough, and diagnosed sleep disorders) increase levels of hemoglobin A1C, an important marker of blood-sugar control, and with it the risk of developing type 2 diabetes,” Fisher says.
“Poor sleep also leads to reduced levels of leptin and elevated ghrelin, two hormones that regulate appetite and metabolism. Ghrelin is an appetite stimulant: The higher the level, the more you want to eat, which can lead to excessive weight gain, putting you at greater risk of heart disease,” Fisher explains.
And there are additional triggers. When we’re tired, the boost of stimulating sugar from a pint of cookie dough ice cream or the comfort of an order of fries can be more appealing than traditional “healthy” food choices.
“During sleep, especially NREM deep sleep, your heart rate and breathing slow down, and your blood pressure lowers,” says Fisher. “Deep rest promotes cell and tissue repair as well as recovery from the stress of the day. Chronic sleep deprivation increases your risk of hypertension, or high blood pressure, one of the leading causes of heart attacks and strokes.”
The American Heart Association — and most sleep specialists — recommends different amounts of sleep for different age ranges.
- Most adults should aim to get seven to nine hours of sleep.
- Kids ages 5 and younger should get 10 to 16 hours of sleep.
- Kids ages 6 to 12 need nine to 12 hours of sleep.
- Teens 13 to 18 should get eight to 10 hours of sleep.
80% of cardiovascular events may be preventable with healthy lifestyle habits, including good-quality sleep
Cardiovascular disease has long been one of the leading causes of death in the U.S. According to the American Heart Association’s 2022 heart disease and stroke statistics update, approximately 121.5 million people in the U.S. have high blood pressure, 100 million have obesity, and more than 28 million people have type 2 diabetes. In 2020, 1 in 6 deaths from cardiovascular disease was due to stroke. Every 40 seconds, someone in the United States has a stroke, and every 3.5 minutes, someone dies of a stroke.
Meanwhile, only 1 in 4 adults reported hitting the physical activity and exercise goals recommended in the U.S. Department of Health and Human Services’ Physical Activity Guidelines for Americans.
Research studies over the past two decades suggest that most cardiovascular disease can be prevented by making healthy lifestyle changes and managing already-known cardiovascular risk factors. Wondering exactly how much is most? More than 80% of all cardiovascular events could be avoided. That’s a huge majority, and it’s important information to know because it means that we have the ability to influence our health by making certain lifestyle choices — eating nutrient-rich whole foods, staying active, managing stress, and sleeping well — to aid in our own heart health.
“The new metric of sleep duration reflects the latest research findings: Sleep impacts overall health, and people who have healthier sleep patterns manage health factors such as weight, blood pressure, or risk for type 2 diabetes more effectively,” says American Heart Association President Dr. Donald M. Lloyd-Jones, who led the advisory writing group.
“We felt it was the right time to conduct a comprehensive review of the latest research to refine the existing metrics and consider any new metrics that add value to assessing cardiovascular health for all people,” Lloyd-Jones says.
How to check your score with the My Life Check tool
You can use the American Heart Association’s My Life Check tool to assess your own heart health. Each component of Life’s Essential 8 has been updated and has a scoring system ranging from 0 to 100 points.
Your overall cardiovascular health score is calculated by averaging the scores for each of the eight health categories. Overall scores below 50 indicate poor cardiovascular health; 50 to 79 is considered moderate cardiovascular health. Scores of 80 and above indicate that you’re living an optimal life to promote heart health.
The advisory group recommends having your cholesterol, blood sugar, blood pressure, height, and weight checked at least once every five years for the most complete and accurate Life’s Essential 8 score.