Poor sleep isn't just tiring — it's a cardiometabolic risk factor

Sleep is no longer just a lifestyle footnote — it's a full-blown cardiometabolic risk factor. At the Cardiometabolic Health Congress in Boston, Dr. Susan Redline of Brigham and Women's Hospital made the case that clinicians should be asking every patient about their sleep at every visit, using open-ended questions to uncover problems across multiple dimensions — not just how many hours they're getting.

The American Heart Association added healthy sleep to its Life's Essential 8 framework for CVD prevention in 2022, and has since expanded that focus beyond duration to include sleep quality and consistency. Conditions like insomnia, obstructive sleep apnea, and periodic limb movements — as well as patterns like irregular sleep timing and low sleep efficiency — are all tied to worse cardiometabolic outcomes.

Key Takeaways:

• Seven domains define sleep quality: duration, timing, regularity, efficiency, alertness, sleep architecture, and disturbed sleep
• The apnea-hypopnea index alone is insufficient — hypoxia depth and duration (measurable via wearables) better predicts heart failure, kidney disease, stroke, and blood pressure, especially in women
• Wearable device data from patients can be a practical clinical tool for monitoring sleep health

Why it matters: Sleep is a modifiable risk factor that's often overlooked in busy clinical settings. Routinely screening for sleep quality could open doors to earlier intervention for some of the most common — and costly — cardiometabolic conditions.