Insufficient sleep linked to higher risk of atrial fibrillation
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- Reviewed by Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing
Growing evidence suggests that insomnia — trouble falling or staying asleep — contributes to many chronic health problems, including heart disease. Now, a study published May 5, 2026, in the Journal of the American Heart Association documents a link between insomnia and atrial fibrillation (afib), the most common heart rhythm disorder.
Researchers looked at health data gathered from nearly 1.8 million Japanese people ages 49 to 68. None had prior evidence of cardiovascular disease, including afib. About 12% had experienced insomnia, which is similar to the rate in the United States.
Over an average of about four years, 1.4% of the people without insomnia and just over 2% of those with insomnia developed afib. After adjusting for common heart-related risk factors (including high blood pressure, diabetes, and sleep apnea), the researchers found that people with insomnia had a 14% greater chance of developing afib. The association was strongest among women and people under age 65.
These observational findings don’t necessarily mean that insomnia causes afib. However, routinely failing to get enough sleep (logging less than seven hours a night) may nudge the nervous system into “fight or flight” mode, causing a rise in heart rate, blood pressure, and levels of stress hormones such as cortisol. That can leave people more vulnerable to factors that can trigger a bout of afib, such as dehydration, drinking alcohol, or eating a large meal. Cortisol may also contribute directly to physical changes in the atria that disrupt the conduction of electrical signals in the heart.
According to the study authors, the findings reinforce the importance of recognizing insomnia as a risk factor for afib, especially since afib can have a major impact on quality of life. Afib affects about 5% of adults in the United States and raises the risk of both stroke and heart failure.
Image: © Filmstax/Getty Images
About the Author
Julie Corliss, Executive Editor, Harvard Heart Letter
About the Reviewer
Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing
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