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Sleepy all the time? Get it checked Correlation found between daytime drowsiness and heart problems in older people Friday, February 04, 2000 By Sally Kalson, Post-Gazette Staff Writer
If you're an older person feeling sleepy a lot during the day, don't automatically discount it as a natural consequence of aging. It could be an early symptom of heart problems that can and should be treated by a doctor.
That's the conclusion of an ongoing national research project that has found a significant correlation between daytime sleepiness and the incidence of heart attacks, congestive heart failure and coronary artery disease among older adults.
The effect is more pronounced in women than in men. Women with daytime sleepiness were twice as likely to have heart disease as their non-drowsy counterparts. For men, the increased incidence of heart problems was 40 percent greater.
A lot of older people think that daytime fatigue is normal for their age, according to Dr. Anne B. Newman, a geriatrician at the University of Pittsburgh and one of the study's lead investigators. In fact, she said, it's really an important indicator of health that should be brought to the attention of a physician.
"The old teaching was that older people should expect to feel tired and ill," she said. "We need to get across to them, and to their children and doctors, that it doesn't matter if they're old. What matters is, can we do something about how they're feeling? If we find a treatable heart condition, we should treat it."
The research was conducted in Pittsburgh and three other cities as part of the long-term Cardiovascular Health Study, begun in 1989 by the National Heart, Lung and Blood Institute.
The largest investigation of its type ever undertaken in the United States, the study was done is to determine risk factors for heart disease in older people. Researchers administered questionnaires to nearly 6,000 subjects 65 and older in Pittsburgh; Winston-Salem, N.C.; Sacramento, Calif.; and Hagerstown, Md. Their average age was 72, and 20 percent were minorities.
Participants were randomly selected from Medicare rolls and covered a wide socio-economic range in urban, suburban and rural areas, so the results are considered applicable to the older population in general.
"Most previous cardiovascular studies did not have enough older people to specifically address the risk factors for heart disease later in life," Newman said.
"We focused on sleep because of reports in middle-aged people that snoring was a risk factor for heart disease. So we asked about snoring and daytime sleepiness in our questionnaires."
Investigators found that many subjects didn't know whether they snored, so no connection could be established. But participants were able to report daytime sleepiness, and those who frequently nodded off during the day had a higher incidence of heart problems.
Researchers are not yet certain why sleepiness and heart disease are related, although they hope an additional study now under way will answer that question.
"People with cardiovascular disease may be more likely to have sleep problems at night that make them tired during the day, so we've added a repeat home sleep study to look at that," Newman said.
The additional study involves bringing specialized equipment to participants' homes to monitor their sleep the same way a hospital would. Those results should be available later this year, and may shed more light on any connection between snoring and heart disease.
In the meantime, Newman said, it's enough for older people to know that a relationship exists between daytime sleepiness and heart disease. "We need to get the message out: If they're tired during the day, they should see their doctor," she said.
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