Good News for Those Who Like to Sleep in on The Weekend

Research on sleep duration and its health effects has consistently shown that both short and long sleep are associated with increased mortality. Some researchers have proposed that extending sleep on weekends might counteract the negative health effects of insufficient sleep during weekdays. However, there has been concern that it could also lead to “social jetlag” in which the body’s circadian cues vary widely from weekday to weekend. There is growing interest in analyzing how different sleep patterns across weekdays and weekends influence long-term health.  

A study by Zhu et al.  examined the impact of weekend catch-up sleep (WCS) on cardiovascular disease (CVD) prevalence and overall mortality. Using data from the 2017-2018 National Health and Nutrition Examination Survey (NHANES), researchers analyzed sleep patterns among 3,400 U.S. adults. The study found that individuals with CVD had significantly shorter WCS than those without the condition. Participants who extended their sleep on weekends had a lower prevalence of CVD, particularly among individuals who regularly slept fewer than six hours on weekdays. Those who increased their weekend sleep by more than two hours experienced a significant reduction in angina, stroke, and coronary heart disease. These findings suggest that WCS may serve as a protective factor against the adverse health effects associated with chronic sleep deprivation, which is increasingly prevalent in modern society and linked to obesity, hypertension, cognitive decline, and higher mortality risk. 

Another study by Akerstedt et al. investigated the relationship between sleep duration and overall mortality in a cohort of 43,880 individuals over a 13-year period. This research confirmed a U-shaped association between sleep duration and mortality, where both short and long sleep durations were linked to increased mortality risk. Among participants under the age of 65, those who regularly slept five hours or less on weekends had a 52% higher mortality rate compared to those who slept seven hours. However, the most significant increase in mortality was observed in individuals who consistently slept either five hours or fewer or eight hours or more across both weekdays and weekends. Interestingly, participants who experienced short sleep durations on weekdays but compensated with longer sleep on weekends did not exhibit increased mortality risk, suggesting that extending sleep on weekends may provide some degree of recovery from weekday sleep deficits. In contrast, no significant associations between sleep duration and mortality were observed in individuals aged 65 and older. 

Both studies have their limitations. They used self-reported data, had little ability to control for significant confounding variables and were not longitudinal in nature. Nonetheless, they underscore the critical role of sleep duration in maintaining overall health. Chronic sleep deprivation has been firmly linked to an increased risk of CVD, as well as heightened mortality. WCS appears to offer some protective benefits, particularly for younger individuals who experience insufficient weekday sleep. Extending sleep on weekends may help counteract some of the negative physiological effects associated with chronic sleep loss, potentially lowering the risk of both cardiovascular conditions and premature death. These insights are crucial for shaping public health guidelines, emphasizing the importance of both sufficient and consistent sleep to promote long-term well-being. Future research should continue to explore the mechanisms behind these findings and determine the optimal balance of sleep needed to maintain health and longevity. 

These findings are particularly relevant for our BetterNight patients as untreated OSA has been strongly associated with an increased risk of CVD and premature mortality. OSA contributes to risk for hypertension, atrial fibrillation, coronary artery disease, heart failure, and stroke due to repeated episodes of hypoxia, sympathetic nervous system activation, and systemic inflammation. Treatment with continuous positive airway pressure (CPAP) has been found to reduce these risks, further supporting the link between OSA and adverse cardiovascular outcomes.