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Do you suffer from unconscious wakefulness?

Kinga Cichewicz on Unsplash

The study below found that people who experience unconscious wakefulness most often and for longer periods of time had nearly double the risk of dying from cardiovascular disease during an average of between 6 and 11 years’ follow-up when compared to the risk in the general population. The association was particularly strong in women and less clear in men.

Unconscious wakefulness also referred to as cortical arousal, is a normal part of sleep. It occurs spontaneously and is part of the body’s ability to respond to potentially dangerous situations, such as noise or breathing becoming obstructed. A full bladder, pain, limb movements, trauma, temperature, light, noise, sleep disorders, acid reflux, depression and anxiety can also be triggers.

Clearly, unconscious wakefulness is a major modifiable risk factor for cardiovascular disease and is also a risk factor for all-cause dementia. Isn’t it about time we took this seriously and started a public health campaign to tackle this problem?

Smartphone technology, which is almost ubiquitous, can be used to screen for this problem and can even be used to tackle the diagnosis and treatment. I have some initial ideas, which need fermenting. Is there anyone out there who wants to help?

 
Shahrbabaki et al. Sleep arousal burden is associated with long-term all-cause and cardiovascular mortality in 8001 community-dwelling older men and women. European Heart Journal, ehab151, https://doi.org/10.1093/eurheartj/ehab151

Aims: To quantify the arousal burden (AB) across large cohort studies and determine its association with long-term cardiovascular (CV) and overall mortality in men and women.

Methods and results: We measured the AB on overnight polysomnograms of 2782 men in the Osteoporotic Fractures in Men Study (MrOS) Sleep study, 424 women in the Study of Osteoporotic Fractures (SOF) and 2221 men and 2574 women in the Sleep Heart Health Study (SHHS). During 11.2 ± 2.1 years of follow-up in MrOS, 665 men died, including 236 CV deaths. During 6.4 ± 1.6 years of follow-up in SOF, 105 women died, including 47 CV deaths. During 10.7 ± 3.1 years of follow-up in SHHS, 987 participants died, including 344 CV deaths. In women, multivariable Cox proportional hazard analysis adjusted for common confounders demonstrated that AB is associated with all-cause mortality [SOF: hazard ratio (HR) 1.58 (1.01–2.42), P = 0.038; SHHS-women: HR 1.21 (1.06–1.42), P = 0.012] and CV mortality [SOF: HR 2.17 (1.04–4.50), P = 0.037; SHHS-women: HR 1.60 (1.12–2.28), P = 0.009]. In men, the association between AB and all-cause mortality [MrOS: HR 1.11 (0.94–1.32), P = 0.261; SHHS-men: HR 1.31 (1.06–1.62), P = 0.011] and CV mortality [MrOS: HR 1.35 (1.02–1.79), P = 0.034; SHHS-men: HR 1.24 (0.86–1.79), P = 0.271] was less clear.

Conclusions: Nocturnal AB is associated with long-term CV and all-cause mortality in women and to a lesser extent in men.

Conflicts of Interest

MS Research

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Disclaimer: Please note that the opinions expressed here are those of Professor Giovannoni and do not reflect the position of the Barts and The London School of Medicine and Dentistry nor Barts Health NHS Trust.
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Comments

  1. Anonymous21 April 2021 at 12:09

    I think I would look at the heart rate variability data that garmin captures. Their stress scores seem fairly plausible and might help.

    Not at all convinced of their sleep tracking, though.

    ReplyDelete
    Replies
    1. Gavin Giovannoni26 April 2021 at 05:03

      Good idea. I will see what can be done via our UK Biobank on this.

      Delete

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