Providing even more evidence that sleep is an essential activity for bodily health, a new study finds that an improper amount of it is linked to markers of heart disease. Previous studies have certainly suggested similar results, but this new one measures the health of the arteries in a couple of different ways, and suggests some possible mechanisms for the connection. Like other studies have found, there seems to be a Goldilocks effect for the right amount of sleep: Seven hours per night seems to be the sweet spot. But sleeping much less or much more than this both seem to pose some problems.

The new study, published in the American Heart Association journal Arteriosclerosis, Thrombosis and Vascular Biology, looked at data from 47,000 people in Korea who filled out questionnaires about their sleep habits. They’d also all had tests to measure calcium buildup in the coronary arteries, and other tests to measure arterial stiffness.

It turned out that people who slept five or fewer hours a night had 50% more calcium buildup in their arteries compared to those who slept seven hours. And sleeping more was not necessarily better: Those who slept an average of nine or more hours had 70% more calcium buildup, again compared to those who slept for seven. And finally, the quality of sleep is also important as its quantity: People who said they had poor sleep quality (waking up multiple times throughout the night) had 20% more calcium compared to seven-hour-a-night’ers.

Similar effects were found for blood vessel stiffness. ”We also observed a similar pattern when we measured arterial stiffness,” said study author Yoosoo Chang. “Adults with poor sleep quality have stiffer arteries than those who sleep seven hours a day or had good sleep quality. Overall, we saw the lowest levels of vascular disease in adults sleeping seven hours a day and reporting good sleep quality.”

The mechanisms aren’t totally clear, and there are probably several at play. It may have to do with the stress that lack of sleep puts on the body, raising levels of the stress hormone cortisol, which itself can lead to inflammation, higher blood pressure, and poor glucose metabolism — all markers of heart risk themselves. But it may also be that underlying health issues can cause too little sleep or excessive sleep, which would be a more complicated relationship. (Talk with your doctor if you’re experiencing sleep disturbances chronically, in either direction; or if your sleep habits suddenly shift, with no clear cause.)

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