Getting enough sleep is important—but how well you sleep matters just as much.
A new scientific report from the American Heart Association shows that healthy sleep involves more than just counting hours.
It also depends on how easily you fall asleep, how regularly you go to bed, whether you wake up feeling rested, and how your sleep patterns affect your daily life and overall health.
This report was published in the journal Circulation: Cardiovascular Quality and Outcomes.
Dr. Marie-Pierre St-Onge, who led the group behind this report, explained that poor sleep habits are now linked to serious health problems.
These include heart disease, high blood pressure, obesity, depression, memory problems, and even diabetes. Dr. St-Onge is an expert in sleep and nutrition at Columbia University in New York City.
The American Heart Association already lists sleep duration—seven to nine hours a night for most adults—as one of eight key elements for good heart and brain health. But recent research shows that simply sleeping enough hours is not always enough.
People who don’t sleep well—even if they stay in bed for the right amount of time—can still face increased risks of stroke, irregular heartbeats (like atrial fibrillation), and conditions like high blood sugar and cholesterol.
So what else makes up healthy sleep? Researchers say there are several parts: how consistent your sleep schedule is, how long it takes to fall asleep, how often you wake up at night, how sleepy you feel during the day, how satisfied you feel with your sleep, and whether your sleep follows normal patterns between light and deep stages.
For example, poor sleep continuity—such as waking up often at night or having sleep apnea—has been linked to heart attacks, high blood pressure, and even problems with how your body uses insulin. These risks may be higher in people who also feel tired during the day.
Sleep timing, or when you usually go to bed, also matters. People who regularly fall asleep after midnight may be more likely to become overweight or develop insulin resistance and high blood pressure.
Not feeling satisfied with your sleep—waking up feeling unrefreshed—is another red flag. Poor sleep satisfaction has been tied to stiffer blood vessels and greater risk of heart disease.
Another problem is irregular sleep schedules. People who go to bed and wake up at very different times every day tend to have more heart issues, higher levels of inflammation, and higher blood pressure that doesn’t drop during the night. On the other hand, people with more regular sleep routines have a lower risk of dying from heart problems.
How sleepy you feel during the day also provides clues. Daytime drowsiness can increase the chance of stroke or death from heart disease. And how your sleep cycles between light and deep stages—called sleep architecture—can also affect heart health, especially when those cycles are disrupted.
The report also looked at how social factors affect sleep. People living in areas with high pollution or noise, or those with lower incomes, tend to have worse sleep. Studies show that people from underrepresented racial and ethnic groups are more likely to sleep less, go to bed later, and suffer from more sleep disorders. These differences can add to health inequalities.
Dr. St-Onge said that it’s important for doctors to ask patients about more than just how long they sleep. Asking about satisfaction, regularity, and daytime functioning can help provide a better picture of someone’s health and may help guide treatment.
The report also calls for better ways to measure and track all these different aspects of sleep so that healthcare providers can better understand and improve sleep-related health issues.
In summary, sleep is not just about quantity. Quality and consistency matter just as much—if not more. Poor sleep can silently harm your heart, your brain, and your overall well-being. And while it’s normal for sleep to change as we get older, serious changes like trouble falling asleep or feeling sleepy all day shouldn’t be ignored.
Dr. St-Onge advises people to pay attention to these signs and talk to their doctor if sleep becomes a problem. Just like eating well and exercising, sleeping well is a key part of staying healthy.
If you care about sleep health, please read studies about refined carbs linked to insomnia risk, and dietary choices for insomnia management.
For more health information, please see recent studies about the natural supplements for sound sleep, and how your diet can improve sleep quality.
The research findings can be found in Circulation: Cardiovascular Quality and Outcomes.
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