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[Preprint]. 2023 Dec 20:rs.3.rs-3678410.
doi: 10.21203/rs.3.rs-3678410/v1.

Association of extreme heat events with sleep and cardiovascular health: A scoping review

Nathan Ashe  1 , Sarah Wozniak  1 , Malcom Conner  1 , Rayan Ahmed  2 , Michelle R Demetres  3 , Nour Makarem  4 , Parissa Tehranifar  4 , Rajalakshmi Nandakumar  5 , Arnab Ghosh  2
Affiliations

Association of extreme heat events with sleep and cardiovascular health: A scoping review

Nathan Ashe et al. Res Sq. .

Update in

Abstract

Background: Extreme heat events (EHEs), driven by anthropogenic climate change, exacerbate the risk of cardiovascular disease (CVD), although the underlying mechanisms are unclear. Disturbances in sleep health, caused by excessive heat, may be one way EHEs increase the risk of incident or recurrent CVD. Our objective was to systematically review the empirical peer-reviewed literature on the relationship between EHEs, sleep health, and cardiovascular measures and outcomes, and narratively describe methodologies, evidence, and gaps in this area.

Methods: A comprehensive literature search was performed in the following databases from inception - June 2023: Ovid MEDLINE, Ovid EMBASE, CINAHL, Web of Science and The Cochrane Library. Studies retrieved were then screened for eligibility against predefined inclusion/exclusion criteria.

Results: Of the 2035 records screened, three studies met the inclusion criteria. Cardiovascular (CV) measures described included blood pressure (BP), heart rate (HR), and HR variability (no CVD outcomes were described) and objective and subjective measurements of sleep health outcomes included sleep duration, calmness, ease of falling asleep, ease of awakening, freshness after awakening, and sleep satisfaction. Two studies were controlled trials, and one was a cohort study. During EHEs, individuals slept for shorter periods of time and less efficiently, with greater degrees of HR variability in two of the three studies lasting at most 1-2 days; BP (both systolic and diastolic) significantly decreased during EHEs in two of the studies. No formal assessment of a mediating relationship between EHE exposure, sleep outcomes, and the CV measures was undertaken.

Conclusions: There is a paucity of data that examines the link between CVD, sleep, and extreme heat as a possible mechanism of elevated CVD risk during EHEs, despite a strong physiological rationale. Further research is needed to empirically test this relationship rigorously as EHEs become more frequent and their deleterious impacts of health increase.

Keywords: Extreme heat events; cardiovascular health; health equity; heat-related sleep disruption.

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Conflict of interest statement

Competing interests: The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Hypothesized model of relationship between EHEs, sleep quality, and CV health.
Figure 2
Figure 2
PRISMA-ScR Flow Diagram From: Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. doi: 10.1136/bmj.n71
See this image and copyright information in PMC

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