New research tracking over 300,000 adults has revealed that middle-aged and older people who naturally prefer late nights show worse cardiovascular health and face higher risks of heart attack and stroke compared to early risers. The association proved especially strong among women.
The good news? Much of this increased risk appears rooted in modifiable lifestyle habits common among night owls, including smoking, poor diet, and insufficient sleep.
Published in the Journal of the American Heart Association, the study examined health data from UK Biobank participants with an average age of 57. Researchers categorized people by their chronotype—their natural preference for sleep and wake times.
Approximately 8 percent identified as “definitely evening people,” typically staying up until 2 a.m. and feeling most energetic later in the day. About 24 percent were “definitely morning people,” preferring earlier bedtimes around 9 p.m. and peak activity in morning hours. The remaining 67 percent fell into an intermediate category.
The findings were striking. Compared to those with intermediate patterns, night owls were 79 percent more likely to have poor overall cardiovascular health scores. Over a median 14-year follow-up period, they also faced a 16 percent higher risk of heart attack or stroke. Women showed a stronger correlation than men between evening preference and poor heart health.
Cardiovascular health was assessed using established measures: diet quality, physical activity, smoking status, sleep quality, body weight, cholesterol levels, blood sugar, and blood pressure.
Early birds, meanwhile, showed 5 percent lower rates of poor cardiovascular health compared to the intermediate group.
“Evening people often experience circadian misalignment, meaning their internal body clock doesn’t match the natural light-dark cycle or their daily schedules,” explained lead researcher Sina Kianersi, a research fellow at Brigham and Women’s Hospital and Harvard Medical School. “This can lead to behaviors that affect cardiovascular health—poorer diet, smoking, and irregular or inadequate sleep.”
Critically, the study identified that lifestyle factors—particularly nicotine use and insufficient sleep—accounted for much of the elevated heart disease risk among evening types.
“The higher heart disease risks among evening types are partly due to modifiable behaviors,” Kianersi noted. “Evening types aren’t inherently less healthy, but they face challenges that make maintaining a healthy lifestyle particularly important. They have real options to improve their cardiovascular health through better sleep habits, quitting smoking, and dietary improvements.”
The research suggests a clear path forward: night owls can significantly reduce their heart disease risk by addressing controllable habits rather than fighting their natural sleep preferences.
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