Night owls may face higher cardiovascular risk, study finds
New research suggests that night owls—people who are more active and alert in the evening—may have a higher risk of cardiovascular events such as heart attacks and strokes compared with those who follow morning or intermediate chronotypes. The study, published in the Journal of the American Heart Association, tracked participants for an average of 14 years and found that evening chronotypes had a 16% higher risk of heart disease than intermediate types.
Sleep and cardiovascular health
In 2022, the American Heart Association updated its heart health framework, Life’s Simple 7, to Life’s Essential 8 by including sleep as a vital component.
Life’s Essential 8 are:
• eat better
• be more active
• quit tobacco
• get healthy sleep
• manage weight
• control cholesterol
• manage blood sugar
• manage blood pressure.
Good quality sleep has been shown to play a critical role in long-term heart health, alongside diet, physical activity, tobacco cessation, weight management, cholesterol control, blood sugar regulation, and blood pressure management.
Researchers theorize that night owls may experience “circadian misalignment,” meaning their natural sleep-wake cycles are out of sync with daily routines. This misalignment can influence brain reward pathways, increasing the likelihood of unhealthy habits such as smoking, alcohol consumption, and poor dietary choices—all of which contribute to cardiovascular risk.
Chronotype and heart health
The study analyzed data from 322,777 adults aged 39–74 from the UK Biobank. Participants self-identified their chronotype, and their cardiovascular risk factors were measured using the Life’s Essential 8 scoring system.
Findings revealed that night owls had lower overall Life’s Essential 8 scores, indicating poorer heart health profiles. In contrast, “larks,” or morning types, tended to have slightly better scores. The analysis confirmed that a “definitely evening” chronotype was associated with a 16% increased risk of heart attack or stroke during follow-up.
Expert insights
Dr. Raj Dasgupta, Chief Medical Advisor for Sleepopolis, explained that while a 16% higher relative risk may seem modest for an individual, it is significant at the population level. “It is comparable to other lifestyle-related risk factors that we routinely address in preventive care,” he noted.
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Dr. William Lu, Medical Director at Dreem Health, highlighted that the true source of risk is circadian misalignment. “Evening chronotypes are more likely to have disrupted sleep patterns, reduced physical activity, and higher blood pressure, all of which contribute to heart disease,” he said.
Actionable advice for night owls
Experts emphasize that evening chronotypes are not inherently unhealthy. Most cardiovascular risk is associated with modifiable behaviors. Dr. Kristen Knutson, Associate Professor at Feinberg School of Medicine, noted that interventions such as improving sleep quality, physical activity, and healthy diet can significantly reduce heart disease risk.
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Practical strategies include morning light exposure for circadian realignment, consistent sleep schedules, exercising earlier in the day, timing meals appropriately, and avoiding nicotine. Dr. John La Puma, internist and preventive medicine expert, emphasized that the focus should be on “environmental adjustments rather than willpower,” making healthy lifestyle changes more achievable.
Takeaway
Being a night owl does not mean an inevitable cardiovascular fate. Awareness of chronotype-related risks and proactive lifestyle adjustments can help evening types maintain heart health and reduce long-term cardiovascular events.
For more detailed insights, read the full study in the Journal of the American Heart Association and follow preventive strategies based on Life’s Essential 8.
Stay informed, stay healthy!
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