Getting Enough Sleep Can Reduce Your Heart Disease Risk, Improve Overall Health
Between 50 and 70 million U.S. adults have a sleep disorder, including insomnia (short-term or chronic) and sleep apnea. Close to 25 percent struggle with sleep in some form on a nightly basis. In fact, the U.S. Centers for Disease Control and Prevention have declared insufficient sleep as a public health epidemic.
In general, you should get 7-8 hours of sleep every day. The quality and consistency of your sleep matter, too and can impact many areas of your health – from daytime performance, memory, energy level and even healing – to more serious issues, like heart disease and type 2 diabetes.
How Does Sleep Affect Your Heart
As a board-certified internist and sleep medicine specialist, I see first-hand how sleep disorders adversely affect risk of heart disease. On the flip side, having heart disease can lead to abnormal sleep.
- Mortality rates from heart attacks and stroke are lowest in people getting seven and eight hours of sleep per night. Getting less than six hours per night or more than 9 hours is associated with over a 1.5 times higher risk of death rate in men and women.
- High blood pressure is a major risk factor for development of heart disease. In people without any underlying disease, sleeping less than five hours per night is associated with a significantly increased risk of elevated blood pressure and more than twice the risk of having a heart attack.
- Inflammation is the driving force behind development and progression of heart disease. Interleukin 2 (IL2) is one of the body's natural anti-inflammatory compounds. Decreased sleep is associated with decreased production of this helpful chemical. Decreased sleep is also associated with higher levels of stress hormones (adrenaline, norepinephrine and dopamine), which cause inflammation.
Diabetes and Sleep
Diabetes is a major risk factor for development of coronary artery disease. Sleep deprivation causes an increase in nighttime cortisol levels which leads to insulin resistance, a cornerstone of type 2 diabetes.
- Compared to people who slept for seven to eight hours, those sleeping only five hours per night doubled the risk of developing diabetes.
- Sleeping more than eight hours per night tripled the risk of diabetes.
- The number one complication of diabetes is heart disease. Seventy percent of Americans over the age of 65 who have diabetes will die from a heart disease-related event.
So, what causes sleeplessness or low-quality sleep? Many factors - from the simple, like too many distractions in your bedroom - to more serious conditions, like obstructive sleep apnea. Even varying your bedtime can affect your sleep and your health. Here are four common sleep issues, how they can impact your heart and how your primary care physician can help you.
In fairly healthy populations, it’s not just the lack of sleep that’s associated with heart health but also timing of sleep. People with irregular sleep patterns have higher risks of heart attacks and heart failure.
- People whose night-to-night sleep length varied by more than 2 hours are more than twice as likely to have a cardiovascular event compared to those whose sleep length varied by less than an hour.
- The time at which they fell asleep at night also mattered. People whose bedtime varied by more than 90 minutes per night were twice as likely to have a cardiovascular event than those whose bedtime was within the same 30-minute time frame.
These variances in sleep timing were found to be related to "digital distraction.” The blue light emitted from TVs, cell phones and iPads decreases the normal release of melatonin, a hormone necessary to signal the body that it’s time to sleep.
My simple advice: put down the phone/ipad, shut off the TV and see how much easier it is to fall asleep. Failing that, wearing blue light-reducing glasses will promote normal melatonin release, helping you to fall asleep naturally. Here are other ways to set up your bedroom to promote sleep.
Obstructive Sleep Apnea (OSA) is one of the most common sleep disorders. OSA occurs when the tongue and soft tissues of the throat repeatedly collapse blocking the airway causing complete or partial cessation of breathing.
- At least 25 million adults in the U.S. suffer from OSA, and OSA increases risk of heart failure by 140 percent, risk of stroke by 60 percent and risk of coronary heart disease by 30 percent.
- OSA is one cause of hypertension and is the underlying cause of up to 80 percent of patients with atrial fibrillation, or AFib.
- Its presence is associated with a two-fold risk of sudden cardiac death during sleep, as well as with increased episodes of angina pectoris (chest pain due to lack of heart blood flow) with a 3.5-fold increase in fatal heart attack when compared to normal adults or those whose OSA is treated with continuous positive airway pressure (CPAP).
- Lifestyle changes: Patients should lose weight and exercise, decrease alcohol consumption, stop smoking, skip sedatives and avoid sleeping on their back. Nasal decongestants and allergy medication may also be recommended.
- Therapies: Positive airway pressure reduces the number of respiratory events that occur as you sleep and reduces daytime sleepiness. A CPAP (continuous positive airway pressure) device is common and effective.
- Surgical Options: Typically recommended as a last resort, surgery is used to remove tissue from the back of the mouth and top of the throat, and in some instances, tonsils and adenoids may be recommended for removal as well. Other procedures may be suggested. Talk with your doctor.
Central Sleep Apnea (CSA) is a different type of sleep apnea caused by congestive heart failure (CHF).
- In this condition, a patient has periods of rapid respiration followed by periods of not breathing at all. These recurring episodes are associated with abnormal heart rhythms.
- Medications used to treat heart failure, like beta-blockers and diuretics can unfortunately cause insomnia.
In addition to CHF medications, treatment options include reducing opioid consumption, using a CPAP devices and, in some cases, implanting a nerve stimulator to help regulate breathing during sleep – similar to a pacemaker.
Restless Leg Syndrome & Periodic Limb Movement Disorder
Other sleep disorders also affect cardiovascular risk. Restless leg syndrome (RLS) and its nocturnal counterpart periodic limb movement disorder (PMLD) are associated with elevated nighttime blood pressures and subsequent elevations of daytime blood pressure. It has been shown to be a cause for left ventricular hypertrophy (enlarged heart).
Now You Know
Striking a fine balance between sleep quantity and quality can help reduce your risk of heart disease and a host of other serious conditions, as well as improve your overall health and quality of life. While not all MDVIP-affiliated physicians specialize in sleep medicine, sleep assessments are among the many tests included in MDVIP’s annual, comprehensive wellness program.
If you are experiencing sleep issues or have a chronic illness that may be causing sleep problems, I encourage you to talk with your doctor or see an MDVIP-affiliated physician. MDVIP-affiliated physicians have the time and tools to help get to the root cause of your sleep concerns and can work with your cardiologist and other specialists to help you rest easy.
This blog reflects the medical opinion of Dr. Mart J. Amick, an MDVIP-affiliated, board-certified internal medicine physician, and not necessarily the opinion of all physicians in the MDVIP national network.