Association of healthy sleep pattern with the risk of falls and fractures among individuals with cardiovascular disease: a UK Biobank study.

Abstract

To investigate the correlation between a healthy sleep pattern and the incidence of falls and fractures in individuals with CVD. A healthy sleep pattern is significantly associated with a lower risk of falls and fractures in CVD patients. This study highlights the importance of sleep management in CVD care. Epidemiological evidence on whether patients with cardiovascular disease (CVD) could benefit from combined healthy sleep behaviors is limited. We prospectively evaluated the association of multiple sleep behaviors with incident falls and fractures in individuals with CVD. Sixty eight thousand nine hundred sixty-one UK Biobank participants with prevalent CVD were included. A healthy sleep score (0-4 points) combined four factors: optimal sleep duration (7-8 h/day), early chronotype, infrequent insomnia, and infrequent daytime sleepiness. Each factor meeting the healthy criteria scored 1 point. Cox regression yielded adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for incident falls and fractures. Over a median follow-up of 13.4 years, 5565 falls, 4080 fractures, and 833 hip fractures were documented. Among CVD patients, 8% lower risks of fall and fracture outcomes were associated with each additional healthy sleep factor. Adjusted HRs (95% CI) for patients with healthy sleep pattern (3-4 scores) compared with patients having poor sleep pattern (0-1 scores) were 0.79 (0.72 to 0.85) for fall, 0.78 (0.71 to 0.86) for all fracture, and 0.79 (0.64 to 0.98) for hip fracture. Individually, both sleep 7-8 h/day and early chronotype were statistically correlated with a reduction risk of fall, all fracture, with HRs ranging between 0.84 and 0.93. A healthy sleep pattern is associated with reduced risk of falls and fractures among CVD patients. Our finding should act as a timely reminder to incorporate sleep into CVD management to prevent subsequent injury.