Sleep Disorders and Cardiovasular Disease - A Close Link
Human beings spend almost one third of their lives sleeping. Adequate sleep is necessary for an optimal daytime functioning and a healthy and productive life. This varies from 6 to 9 hours, the average being 6. 85 hours. Unfortunately Americans are getting less sleep today than ever before. In 2005, forty percent of adults reported sleeping less than 7 hours per night, much higher than the 15% in 1960. Lack of proper sleep often causes daytime tiredness, lack of energy, difficulty concentrating and irritability. A restful sleep allows the body to recover both physically and mentally from the rigors of the day. Author Chamfor may have rightly said, "Living is a disease from which sleep gives us relief eight hours a day."
"Sleep is the interest we have to pay on the capital which is called in at death; and the higher the rate of interest and the more regularly it is paid, the further the date of redemption is postponed." Arthur Schopenhauer (German Philosopher, 1788-1860). It is important to get adequate sleep every night, otherwise you may get sick or even die early. . Thomas Dekker, Renaissance dramatist, proclaimed, "Sleep is the golden chain that ties health and our bodies together." Sleep deprivation induces a myriad of abnormal physiologic changes. When sleep is disrupted short term there is decreased vigilance and reaction time with an increased risk of daytime accidents. People develop a depressed mood, decreased memory, high blood pressure, abnormal sugar control, dyslipidemia, metabolic syndrome and increased inflammation. Long-term health consequences include premature death, cardiovascular disease and diabetes. There are also detrimental mental effects, reduction in physical functioning, and a decline in the overall quality of life. Sleep deprivation is an independent risk factor for the development of obesity in children and adolescents.
Sleep disorders are common. Although there are over 100 sleep related disorders, insomnia, sleep apnea, narcolepsy, hypersomnia and restless leg syndrome are the top five. Insomnia affects about half the population. Insomnia is characterized by difficulty in falling asleep, difficulty in maintaining sleep, waking up too early in the morning or experiencing a non-refreshing sleep. Sleep apnea is of two types. Central sleep apnea, occurs when the brain fails to send the appropriate signals to the breathing muscles to initiate respiration. Obstructive sleep apnea is far more common and occurs when air cannot flow into or out of the person's nose or mouth even though efforts to breathe continue. It is typically associated with obesity and snoring. Narcolepsy is characterized by an overwhelming excessive daytime sleepiness , in spite of an adequate night time sleep. Excessive sleepiness may also be due to central nervous system diseases or medications. Implicated medicines include tranquilizers, antihistamines, antidepressants, antipsychotics, antihypertensives, and long-acting hypnotics, as well as withdrawal of stimulants. Patients with the restless leg syndrome experience involuntary twitching or jerking ovements of the legs during sleep with a strong urge to move them for relief.
Recent science as focused on the detrimental effects on the cardiovascular system from sleep disorders. A ten-year follow-up of the Nurses' Health Study demonstrated that short sleep time was associated with a higher risk of developing coronary heart disease. In the Japanese segment of the study, patients with a short sleep time ( about 5 hours per night) were found to have a 2- to 3-fold increased risk for heart attacks. Sleep deprivation is also harmful to the metabolic system. In a report published in the April 25, 2005 issue of the Archives of Internal Medicine, sleep duration of six hours or less or nine hours or more was associated with increased prevalence of diabetes mellitus and impaired glucose tolerance. Qureshi studied 7884 persons older than age 31 years, and found that excessive sleep was associated with a 50% increase in stroke and an overall higher mortality. These findings were reported in the journal of Neurology in 1997. In a recent study, published in the April 17, 2007 edition of the Journal of the American College of Cardiology, researchers from Toronto followed 164 patients with heart failure for more than seven years. They found that those with obstructive sleep apnea had double the death rate when compared to those patients who did not have sleep apnea. Sleep apnea is typically characterized by loud snoring. Epidemiological evidence has implicated snoring as an independent risk factor for the development of not only hypertension and ischemic heart disease, but also strokes. Anthony Burgess said, " Laugh and the world laughs with you, snore and you sleep alone. " And unfortunately, we have to add - and die early.
Health disorders can also prevent proper sleep. Conditions such as pain, Lung diseases, congestive heart failure and pregnancy can interfere with proper restful sleep. Depression and anxiety often causes insomnia. Excessive coffee, cigarettes, or alcohol, especially teken late in the evening may cause or aggravate sleep problems. Aging also affects sleep patterns and elderly people may sleep much less at night.
" The best cure for insomnia is to get a lot of sleep." W. C. Fields quotes (American Comic and Actor, 1880-1946). Here are a few tips from the National Sleep Foundation to help you an adequate and refreshing sleep: ' Avoid caffeine, nicotine and alcohol in the late afternoon and evening. Establish a regular, relaxing bedtime routine that will allow you to unwind and send a "signal" to your brain that it's time to sleep. Avoiding exposure to bright light before bedtime. Taking a hot bath can help. Make your sleep environment as pleasant, comfortable, dark, and quiet as you can. Try not to nap during the day if you have trouble sleeping at night. Exercise regularly, but do so at least three hours before bedtime. Don't use your bed for anything other than sleep or sex. If you can't go to sleep after 30 minutes, don't stay in bed tossing and turning - involving yourself in a relaxing activity, such as listening to soothing music or reading, can help you to feel sleepy. Do not watch television or engage in other potentially stimulating activities immediately prior to sleep. '
Epidemiological studies show that 7-8 hours of sleep each night is associated with the lowest mortality and morbidity. " Sleep is the best meditation. " Dalai Lama quotes ( Spiritual Leader, 1989 Nobel Peace Prize Winner). And sleep may also help relieve depression and anxiety, " The best bridge between despair and hope is a good night's sleep. " E. Joseph Cossman. So develop a good sleep discipline and hygiene. And as Henry Wadsworth Longfellow said " Be thy sleep silent as night is, and as deep. " Have a good night!
Related Tags: insomnia, sleep, heart
Dr. Shashi K. Agarwal is a Board Certified Internist and Cardiologist with a private practice in New York City and New Jersey. He is also a Diplomate of the American Board of Holistic Medicine and the American Academy of Anti-Aging Medicine.
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