Stress and insomnia are linked to irregular heart rhythms after menopause

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After menopause, it is estimated that one in four women may develop irregular heart rhythms (known as atrial fibrillation) in their lifetime, with stressful life events and insomnia being major contributing factors.

The data comes from new research published in the Journal of the American Heart Association, which also warns that atrial fibrillation can lead to blood clots, strokes, heart failure or other cardiovascular complications.

Stress and insomnia are linked to irregular heart rhythms after menopause

The study’s lead author, Susan. X. Zhao, a cardiologist at Santa Clara Valley Medical Center in San Jose, Calif., said that in addition to age, genetics and other risk factors related to heart health, psychosocial factors are the missing piece in the puzzle of the genesis of atrial fibrillation.

The researchers reviewed data from more than 83,000 questionnaires completed by women ages 50 to 79 from the Women’s Health Initiative, a major US study. Participants were asked a series of questions in key categories: stressful life events, their sense of optimism, social support, and insomnia.

Questions about stressful life events address topics such as the loss of a loved one; disease; divorce; financial pressure; and domestic, verbal, physical or sexual abuse. Questions about sleep habits focused on whether participants had trouble falling asleep, waking up multiple times during the night, and overall sleep quality, for example.

And, questions about participants’ perspective on life and social supports addressed having friends with whom they talk during and about difficult or stressful situations; a feeling of optimism, such as believing that good things are on the horizon; and have help with daily tasks.

The connection between the heart and the brain

Over about a decade of follow-up, the study found that about 25 percent of the women (23,954 women) developed atrial fibrillation; a two-group system (the stress group and the strain group); and that, for every additional point on the insomnia escalation, there is a four percent greater chance of developing atrial fibrillation. Similarly, for each additional point in the escalation of stressful life events, there is a two percent higher probability of experiencing atrial fibrillation.

“The connection between the heart and the brain has been established for a long time in many conditions,” Zhao said. “Atrial fibrillation is a disease of the electrical conduction system and is prone to hormonal changes resulting from stress and lack of sleep. These common pathways likely underpin the association between stress and insomnia with atrial fibrillation,” she explained.

The researchers found that stressful life events, lack of sleep, and feelings such as depression, anxiety, or feeling overwhelmed by one’s circumstances are often interrelated.

It is difficult to know if these factors gradually accumulate over the years to increase the risk of atrial fibrillation as women age. Chronic stress has not been consistently associated with atrial fibrillation, and the researchers note that one limitation of their study is that it relied on patient questionnaires used at baseline.

However, stressful life events, while significant and traumatic, may not be long-lasting, Zhao noted. Further research is needed to confirm these associations and to assess whether personalized stress relief interventions can modify the risk of atrial fibrillation.

As women live longer they may face increased risk and worse outcomes associated with atrial fibrillation. While high blood pressure, obesity, type 2 diabetes, and heart failure are recognized risk factors, more research is needed on how exposure to psychosocial stress and general emotional well-being over time may affect potential development. of atrial fibrillation.