I’ve always struggled with inconsistent sleep, staying up late and waking up at different times each day. My love for coffee was also on an all-time high with trying all the season specials. But it is only recently, I learned how this irregular sleep pattern and caffeine could increase my risk of heart attack and stroke. Now, I’m prioritizing a consistent sleep schedule and cutting out caffeine after 3 PM to protect my heart.

A new, shocking study shows that irregular sleep patterns can greatly increase the risk of heart attack and stroke. But that's not all: the timing of your caffeine intake could also play a critical role in your cardiovascular health. If you are struggling with inconsistent sleep patterns and regularly sipping on caffeinated beverages late in the day, you may be unknowingly putting yourself at risk for serious heart-related issues.

For most people, sleep is something of a given and we often only consider ourselves as long as we get our required seven to nine hours. However, according to a recent study conducted by researchers at the Children's Hospital of Eastern Ontario, it may not be that long after all. The study, which included more than 72,000 participants, found that people with irregular sleep patterns—those who fall asleep and wake up at vastly different times each day—face a 26% higher risk of experiencing a heart attack or stroke. This increased risk persisted even for those who managed to get enough sleep. The study followed up participants for eight years to track heart events such as heart attacks, strokes, and heart failure. The conclusions were clear: irregular sleep, even if it's sufficient in duration, is a major cardiovascular risk factor.

The researchers found that those whose sleep patterns were highly irregular had a significantly greater chance of life-threatening heart issues. The more erratic your sleep schedule, the greater the risk, regardless of how many hours you sleep. In fact, people with irregular sleep schedules showed worse cardiovascular health outcomes, including higher rates of high blood pressure, elevated stress hormones, and poor blood sugar and cholesterol management.

Senior scientist Dr. Jean-Philippe Chaput said "sleep regularity may be more relevant than sufficient sleep duration in modulating MACE [major adverse cardiovascular event] risk." In the study, it shows that our bodies are comfortable with consistency, and a varied sleep schedule may interfere with other processes that keep us healthy, especially the heart.

Is it Caffeine After 3 PM Causing Sleeplessness?

Another daily habit that may be putting your heart at risk is caffeine consumption after 3 PM. According to Dr. Chaput, the experts emphasize the need for a healthy sleep schedule and avoiding caffeine late in the day. Caffeine can stay in your blood for up to eight hours, and its consumption later in the afternoon can disrupt your sleep cycle.

Consistent, good-quality sleep is necessary for maintaining healthy cardiovascular function, and the disruption of this by late-day caffeine intake exacerbates the risks posed by irregular sleep. When you drink coffee, tea, or other caffeinated beverages too late, the stimulant effect on your nervous system makes it harder to fall asleep at a regular time. This can lead to inconsistent sleep patterns, which, as we have seen, can be harmful to heart health.

Dr Chaput insists that humans need to adopt practices that contribute to regularized sleep habits. This can be attained by establishing a proper sleeping and waking schedule, eliminating afternoon intake of stimulants such as caffeine, and making your body clock coincide with the lifestyle one leads.

How Does Poor Sleep Affect Heart Health?

According to the experts, the disturbance due to irregular sleep patterns impacts more than one physiological process involved in the maintenance of the healthy heart. For example, poor sleep can be associated with increased inflammation of the body, weakened immunity, and altered regulation of blood sugar and cholesterol, all of which contribute to increased blood pressure and weakening endothelial function, both associated with an increased risk for cardiovascular diseases. Sleep also plays a very important role in regulating stress hormones. Poor or disturbed sleep results in increased levels of cortisol, the stress hormone, which increases blood pressure and can have negative impacts on cardiovascular health over time.

Scientists hypothesize that these disturbances trigger a series of negative effects that enhance the risk of developing chronic heart conditions, including hypertension, atherosclerosis, or even heart failure.

Tips to Protect Your Heart and Improve Your Sleep

In order to protect your heart, experts recommend several proactive measures to improve your sleep patterns and lifestyle. First, maintain a regular sleep schedule whereby you go to bed and wake up at the same time every day, including weekends. Consistency will keep your body's internal clock in check.

Along with regulating your sleep, paying attention to your caffeine habits is just as important. To reduce your risk of heart disease and stroke, experts suggest avoiding caffeine after 3 PM. If you’re sensitive to caffeine, this rule becomes even more critical.

In addition, the introduction of stress-reducing activities like yoga or mindfulness can also be beneficial to lower cortisol levels, and therefore both sleep and heart health can improve. A diet rich in antioxidants, healthy fats, and low on processed sugars also helps maintain cholesterol levels and reduce inflammation.

Does Your Sleep Environment Also Has A Role To Play

Apart from the timing of caffeine and your sleep schedule, another very overlooked factor is the quality of your sleep environment. Scientists have long known that the environment in which you sleep has a huge impact on the quality of your rest. Poor quality of sleep, even if your sleep schedule is regular, can cause health risks that are very much the same as those that arise from irregular sleep patterns.

Here’s an additional tip: make sure your bedroom is conducive to restful sleep. This means keeping your room dark, quiet, and cool. A temperature of around 65°F (18°C) is ideal for most people. Consider investing in a comfortable mattress and pillows, and avoid screen time at least 30 minutes before bed to allow your brain to unwind.

Irregular sleep, in association with taking caffeine in late parts of the day, can risk heart attack and stroke, but a simple maintenance of a sleep schedule, the reduction of consumption of afternoon caffeine, and sleep environmental awareness can definitely safeguard one's heart along with total health.

Your sleep is more than just a time for rest; it's a vital component of your long-term health, and maintaining consistency in your sleep habits is one of the best things you can do for your heart.

CFor years, polycystic ovary syndrome (PMOS) has been characterised with irregular periods, excess hair growth, infertility, and weight gain. But doctors have increasingly been emphasising that it is a far more complex condition.

With metabolic conditions like insulin resistance, dyslipidaemia, fatty liver, and increased risk of diabetes forming an important part of the diagnosis, the condition has been rightly re-termed as Polyendocrine Metabolic Ovarian Syndrome (PMOS).

When the metabolic symptoms of PMOS came into focus, a a newer class of medicines, GLP-1 receptor agonists like semaglutide, began attracting attention.

Drugs like Ozempic and Wegovy were developed primarily for diabetes and obesity, not as universal treatments for PMOS.

Yet their ability to help lose weight and improve metabolic health has raised an important question: are GLP-1 drugs actually changing how doctors treat PMOS, or are they simply becoming another tool for managing obesity and insulin resistance in women who also have PMOS? According to experts, the answer is not that simple.

As September is PMOS Awareness Month, we take a closer look at how GLP-1 weight loss drugs are changing PMOS treatment.

GLP-1 Drugs Target The Metabolic Side of PMOS

HealthandMe spoke to Dr. David Chandy, Director of the Department of Endocrinology and Diabetology at Sir H. N. Reliance Foundation Hospital, Mumbai, who said that PMOS does not present identically in every woman.

“GLP-1 drugs are changing the treatment of the metabolic component of PMOS, rather than becoming a treatment for every aspect of PMOS. PMOS is not a disease with one presentation. Some women are lean, some have significant obesity, some predominantly have menstrual irregularity or excess hair growth, while others have marked insulin resistance, prediabetes or diabetes.”

Talking to HealthandMe, Dr. Sujith Ash, Consultant Obstetrician and Gynecologist at P. D. Hinduja Hospital & Medical Research Centre, Khar West, Mumbai, similarly stressed that PMOS needs to be understood as a broader metabolic and reproductive condition.

“What you first need to understand is whenever we are thinking about PMOS, it is a huge umbrella under which a lot of organs are implicated. So, it is not just the period-related issues that we are dealing with, we are also dealing with liver implications where your metabolism is affected, memory and exhaustion, and insulin resistance.”

Dr. Trupti Prasad, Endocrinologist at LH Hiranandani Hospital, told HealthandMe that the shift in understanding PMOS as a metabolic disorder is important when considering GLP-1 drugs.

She said, “As we know, there is a change in the name of PMOS to PMOS. It's now more considered as a metabolic disorder rather than just focusing on the ovaries and reproductive functions.”

She added that insulin resistance is one of the central mechanisms involved in PMOS and can have consequences beyond reproductive health.

“GLPs are definitely one of the main core pathology, pathophysiology of PMOS is the insulin resistance. So one of the main mechanisms by which GLP would help here is insulin resistance and weight reduction. But insulin resistance comes with complications like dyslipidemia, cholesterol disorders and even fatty liver.”

Also read: Weight Loss Surgery May Improve Irregular Periods And Other PMOS Symptoms

Having PMOS Does Not Automatically Mean You Need Ozempic Or Wegovy

One of the biggest concerns surrounding GLP-1 drugs is the perception that a woman with PMOS and excess weight should automatically be prescribed one. Experts warn against this strategy of treatment.

“Having PMOS alone is not an indication to start a GLP-1 drug.” Chandy said. “The first question should be whether the woman has overweight or obesity significant enough to justify medical treatment according to accepted obesity-treatment criteria.”

He said GLP-1 treatment becomes more relevant when excess weight is accompanied by metabolic complications.

“I would particularly consider it when there is significant excess weight or central obesity with problems like insulin resistance, prediabetes, type 2 diabetes, fatty liver, dyslipidaemia or other weight-related complications, especially when lifestyle measures alone have not achieved sufficient results.”

Conversely, she said a woman with lean PMOS or someone seeking to lose a small amount of weight for cosmetic reasons should not automatically be placed on semaglutide.

Prasad said doctors also use BMI and the presence of metabolic complications when considering these medications.

She also noted that Indian thresholds can differ from Western obesity criteria because metabolic diseases can occur at lower BMI levels in Indian populations.

“We use a cut-off of 25 with one comorbidity or above a 27 BMI irrespective of comorbidity. So the patient with this criteria of a BMI of 25 and has a PMOS obviously would go for the GLP-based therapies.”

Ash said assessment should go beyond weight alone. He says, “The other thing would be insulin resistance. We ask for a fasting insulin level in these patients along with the sugars and the cholesterol and the lipid profile basically, your fasting blood sugar, your HbA1c.”

Also read: Thin Outside, Fat Inside: Why A Slim Body May Still Hide Metabolic Health Risks?

Effects Of GLP-1 Drugs On Other Symptoms Of PMOS

Weight loss is currently the most established effect of GLP-1 drugs in this context. But researchers and clinicians are also interested in whether the improvement in metabolic health can translate into changes in other features of PMOS.

Dr. Chandy said the evidence is strongest for metabolic outcomes like weight reduction and insulin resistance. There are also signals of reproductive benefits, although the evidence is not equally strong for every outcome.

Dr. Chandy said, “There is encouraging evidence that menstrual cycles may become more regular. Some studies show improvements in sex hormone-binding globulin and modest reductions in androgen levels.”

However, he cautioned against treating these findings as established evidence that GLP-1 drugs directly treat every manifestation of PMOS. He added, “The effects on hyperandrogenism are inconsistent, and we do not yet have sufficiently strong evidence to say that GLP-1 drugs are treatments for hirsutism or acne.”

Dr. Ash explained why improving insulin resistance could have effects that extend beyond body weight. He said, “When I'm looking into the insulin resistance picture of PMOS, the major effect in the patient is not just the weight. It is the insulin that leads to the androgenic effects.”

He said insulin resistance can contribute to menstrual abnormalities and other symptoms. According to Dr. Ash, improving insulin sensitivity can reduce hyperinsulinaemia and potentially influence androgen levels and menstrual regularity.

“When GLPs are introduced in your body, GLPs will improve the insulin sensitivity. And once the hyperinsulinemia reduces, then that will help in suppressing the appetite. So, then weight balancing is better. Also, with the insulin resistance becoming better, the androgenic levels or the male hormone levels, which are increased in PMOS, PMOS, that is also better.”

Also read: From Insulin Resistance to Fertility: Understanding the Metabolic Side of PCOS

GLP-1 Drugs Vs Metformin

Metformin has long been used in PMOS treatment, particularly when insulin resistance and metabolic abnormalities need to be addressed. The arrival of GLP-1 drugs has therefore raised the question of whether they could eventually replace the older drug. Experts say that is not how the comparison should currently be viewed.

Dr. Chandy said both drugs are meant for different conditions. Metformin has decades of clinical use behind it, while GLP-1 drugs generally produce substantially greater weight loss.

The expert said, “Metformin has been used in PMOS for decades. It is inexpensive, we have extensive long-term safety experience, and it remains useful particularly for insulin resistance and metabolic abnormalities. GLP-1 drugs generally produce much greater weight loss than metformin. Therefore, in a woman with PMOS and significant obesity, a GLP-1 drug may have a much larger metabolic impact.”

Prasad similarly said GLP-1 drugs could offer an advantage when significant weight reduction is a major treatment objective. But she said it is too early to conclude that GLP-1 drugs will replace metformin.

Dr. Ash highlighted the fact that there is a depth of long-term evidence. He said, “The only deciding factor is that the effects are quicker in GLPs, but it is not something that I can do for a long period. Whereas metformin, I can do it for a longer period. And there are not enough studies which are based around the preconception and pregnancy aspects along with GLPs, which are there with metformin.”

Also read: Meet Louise Brown- The World’s First IVF Baby

Could Better Metabolic Health Improve Fertility?

One of the most intriguing parts of the GLP-1-PMOS conversation is fertility. Some women report that their periods become more regular after losing weight on GLP-1 drugs.

For women whose PMOS is associated with insulin resistance and irregular ovulation, this can improve the hormonal environment needed for ovulation. But experts caution against interpreting this as proof that semaglutide itself is a fertility drug.

Chandy explained that improving insulin resistance can improve reproductive effects. He said, “When a woman with PMOS loses significant weight and insulin resistance improves, insulin levels fall. High insulin levels can stimulate the ovary to produce more androgens and can interfere with normal follicular development and ovulation.”

There may be biological effects of GLP-1 signalling on reproductive issues as well, but Chandy said the clinical significance of these findings remains uncertain.

“There may also be direct effects of GLP-1 signalling on the reproductive system and the ovary, and there is interesting experimental research in this area. But clinically, I think it is premature to say that semaglutide is directly stimulating fertility.”

Women With PMOS Trying To Conceive & GLP-1 Drugs

This is where the difference between improving metabolic health before pregnancy and taking a GLP-1 drug during pregnancy becomes important. Prasad said this preconception can influence pregnancy outcomes.

“Pre-pregnancy parameters are very important in deciding upon what complications arise during the pregnancy. So ideally a normal body weight before pregnancy, even HB1C control should be less than 6.5, normal blood pressure, that is what we look for once a person goes for pregnancy.”

She said GLP-1 treatment can help women before conception, but the medication needs to be stopped before pregnancy. She said, “We have to stop at least two months prior to a planned pregnancy. So current data is not there for use during the pregnancy.”

Chandy similarly said GLP-1 drugs may have a role as a preconception metabolic intervention, rather than a pregnancy or fertility treatment. He also addressed the issue of discontinuing treatment.

Dr. Chandy said, “Another important issue is weight regain. Once GLP-1 therapy is stopped, appetite can increase again and some weight may return. So we need a long-term plan involving nutrition, physical activity and, where appropriate, other metabolic treatments rather than simply stopping the injection and hoping that the benefit remains permanently.”

As GLP-1 drugs become increasingly popular, doctors say one of the biggest risks is reducing a complex condition to a prescription for weight loss. Chandy said PMOS remains a lifelong reproductive and metabolic condition and GLP-1 drugs do not cure it. He also cautioned against viewing GLP-1 drugs as fertility medications. He said for women with PMOS and anovulatory infertility, established fertility treatments remain important.

He said, “The second misconception is that these medicines are fertility drugs. Some women certainly notice more regular periods and may start ovulating after significant weight loss, but that actually means that pregnancy can become possible unexpectedly. Women need to be counselled about contraception because these drugs should not be used during pregnancy.”

Ash said patients also need to understand that medication alone cannot substitute for sustained lifestyle changes.

“The entire idea of using any of the GLPs is that in that few months that we are doing the GLPs, you have to make sure your lifestyle changes even more disciplined, more religious and you follow that lifestyle. So the important part is forming the lifestyle as a habit which will continue for a longer period.”

Prasad stressed that the metabolic component of PMOS requires long-term attention rather than a short course of treatment.

“I want patients to understand that PMOS, as the name suggests, it's a metabolic complication which remains within the person throughout their life. It's not only about the ovaries, not only about the irregular periods or about the infertility issues. It's something which starts maybe like in a young age and it remains with you throughout your life.”

For the first time, the number of centenarians in Japan has exceeded 100,000. According to the latest figures from the health ministry, the country now has 107,677 people aged 100 and above, of whom 88% are women.

The oldest woman is Kishimoto Fuyo, a 114-year-old from Kyoto City, while the oldest man is Kato Hikaru, a 112-year-old from Kumamoto.

Health Minister Kenichiro Ueno told reporters he was “delighted that so many people are living long, healthy and active lives”. Citing progress in medicine and technology behind the long life, Ueno also warned about the challenge of maintaining a sustainable social security system.

Why Is Japan A Super-Ageing Society?

The long lives of Japanese people may be attributed to several factors, including genetics, a healthy diet and an active lifestyle.

The island nation’s cuisine predominantly consists of fish, vegetables and rice, with less saturated fat than many Western diets. Older people also regularly walk, use public transport, cycle and stretch.

However, Japan’s ageing population is linked to two major demographic trends: low birth rates and longer life expectancy.

Fertility falling below the replacement level means fewer younger people are entering the population, while improvements in healthcare allow people to live longer.

To curb the falling fertility rates, the government in 2023 launched programs aimed at increasing the birth rate, including a 3.5-trillion-yen (US$22.5 billion) increase in family-policy spending.

However, the country's total fertility rate still dropped to a record low of 1.14 in 2025, far below the 2.1 children needed to maintain the current population.

On the other hand, there were 153 people aged 100 or older when centenarian surveys began in 1963. The number exceeded 1,000 in 1981 and surpassed 10,000 in 1998, according to the Health and Welfare Ministry.

Also read: Unusually High Cancer-Fighting Immune Cells Could Explain Why Some People Live Beyond 100: Study

What Are The Challenges Of A Super-Ageing Society?

The World Health Organization defines “super-ageing” societies as countries where more than 20% of the population is aged 65 or older.

As the proportion of older adults grows relative to the working-age population, population ageing can place pressure on healthcare systems, economies and social support structures. It can also contribute to challenges such as pension pressures, labor shortages and increasing demand for long-term care.

An ageing population can increase the need for continuous medical care, caregiving and social support, due to

• Chronic disease burden of heart disease, diabetes, cancer and cognitive
• Resource strain, where Hospitals and nursing homes face shortages of specialized geriatric care personnel and integrated support services.
• Social isolation, where loss of community engagement and inadequate public transportation or age-friendly housing can increase vulnerability.
• Elder mistreatment: Social and family abuse, alongside systemic ageism, can undermine the dignity and safety of older citizens.

Read More: Normal Ageing or Alzheimer's? Doctors Explain Six Key Differences to Watch For'

Ageing Is Becoming A Global Challenge

Japan’s demographic shift is part of a broader global trend. According to WHO, by 2030, one in six people worldwide will be aged 60 or older. The number of people aged 60 and above is projected to rise from 1 billion in 2020 to 1.4 billion by 2030.

By 2050, the global population aged 60 and older is expected to reach 2.1 billion. The number of people aged 80 or older is also expected to triple between 2020 and 2050, reaching 426 million.

By 2050, two-thirds of the world’s population aged over 60 is expected to live in low- and middle-income countries.

Population ageing therefore has implications not only for how long people live, but also for healthcare, caregiving, social support and the size of the working-age population.

A commonly used antibiotic for pneumonia, urinary tract infections (UTIs) and certain skin infections has been linked to higher odds of death in adults, according to a new study.

The antibiotic, cefepime, is a cephalosporin that is relatively stable against AmpC β-lactamases, enzymes produced by some bacteria that can contribute to antibiotic resistance.

Concerns about a possible link between cefepime and mortality have been raised for years. A new systematic review and Bayesian meta-analysis has now re-examined the evidence from randomized clinical trials.

What Did The Study Find?

The study, published in JAMA Network Open, analyzed 110 randomized clinical trials involving 22,608 patients who received either cefepime or another β-lactam antibiotic.

Researchers found a 94.4% posterior probability that cefepime was associated with higher odds of death compared with other β-lactam antibiotics. Death occurred in 6.6% of patients treated with cefepime and 6.2% of those in the comparison groups.

The mortality signal was concentrated in adults, while the analysis did not find evidence of increased mortality in children. Researchers also found higher probabilities of harm across several clinical indications and with cefepime doses of 2 grams or more every 12 hours.

The highest probability of increased mortality was seen among patients treated for febrile neutropenia, at 96.1%.

Also read: 98 Years After Penicillin, Are We Running Out Of Effective Antibiotics?

Why Is Cefepime Safety A Concern?

Cefepime remains an important antibiotic used to treat serious bacterial infections, including pneumonia, UTIs, skin infections and febrile neutropenia.

Its current FDA-approved uses also include certain complicated intra-abdominal infections when used with metronidazole.

One concern with cefepime is neurotoxicity. The drug's prescribing information warns about neurological reactions, particularly in patients with kidney impairment when the dose is not appropriately adjusted. Reported reactions can include confusion, encephalopathy, myoclonus and seizures.

The question of whether mortality is directly caused by cefepime, however, remains unresolved.

An accompanying commentary in JAMA Network Open argued that the mortality findings may be related to dosing and drug exposure rather than cefepime itself.

The drug is typically administered via injection by healthcare providers in a clinical setting. Severe side effects may include confusion, decreased consciousness or seizures, especially in older patients and those with kidney problems, among many other common symptoms, according to Mayo Clinic.

Cefepime And The Earlier Mortality Debate

Read More: Nearly All Countries Overuse Antibiotics; 60% Still Use WHO-Discouraged Drugs: The Lancet

Concerns about cefepime's safety are not new. A 2007 meta-analysis reported a 26% higher relative risk of death among patients receiving cefepime compared with other β-lactam antibiotics.

The FDA subsequently analyzed a larger set of clinical trials and reported no statistically significant difference in mortality between cefepime and comparator antibiotics.

However, the researchers have also rated the overall certainty of evidence as moderate. They downgraded it because of differences between studies and possible publication bias, including 25 unpublished trials supplied by the US Food and Drug Administration that showed results in the opposite direction from the published literature.