What
  • Sleep
  • Sleep Medicine Doctors
  • Sleep Medicine Centers
  • Sleep Therapists
  • Oral Appliance Dentists
  • Pulmonary Sleep Medicine
  • Allergy Sleep Medicine
  • Ear Nose and Throat Sleep Medicine
  • Pediatric Sleep Specialist
  • Sleep Medicine Surgeons
  • Neurology Sleep Medicine
City
author Image

Irregular Sleep and Heart Disease

Irregular-Sleep-and-Heart-Disease (1)

 
Medically reviewed by
Dacelin St Martin, MD
Triple board-certified in Sleep Medicine,
Internal Medicine, and Pediatrics.

 
 

The Relationship Between Sleep and Heart Disease | Sleep Conditions that Affect Heart Health | How Much Sleep Do You Need? | Improving Sleep to Protect Heart Health | What’s the Takeaway?

 

Overview

Though a condition predominantly attributed to poor diet and lack of physical activity, recent studies have highlighted the connection between heart disease and sleep.[1][2] 

We’ve all known that a good night’s sleep is good for your health. Unfortunately, however, a good night’s sleep isn’t the norm for most. With estimates suggesting around 70 million Americans get insufficient sleep, it begs the question – to what extent is irregular sleep damaging the cardiovascular health of our nation?[3]

 

The Relationship Between Sleep and Heart Disease

Sleep is an essential modulator of our cardiovascular health.[2] With cardiovascular disease (CVD) accounting for the most considerable mortality rate globally, attending to preventative factors such as improving sleep quality becomes necessary.[4]

It has been proven that in addition to the increased risk of cardiovascular events attributed to chronic short sleep, both poor quality sleep and short sleep durations can result in the aggravation of cardiovascular disease risk factors, including high blood pressure, high cholesterol, and atherosclerosis.[5]

Thus, those who do not get enough sleep can end up damaging their hearts by:

  • Gaining More Weight 

Poor sleep quality can interfere with metabolism, increase our appetite, lower energy expenditure, and promote the consumption of ‘unhealthier’ foods, thereby increasing the risk of obesity – a significant CVD risk factor.[6]

  • Diabetes 

It has been shown that losing a couple of hours of sleep each night can increase your risk of developing type 2 diabetes.[7]

  • Inflammation 

A well-established but under-utilized risk factor for CVD, inflammation, has been linked to sleep deprivation. Inflammatory processes that promote the formation of plaques in the blood vessels have been associated with sleep deprivation.[8]

  • Acute Coronary Event 

A lack of or too much sleep can cause high blood pressure and increase circulating ‘bad’ cholesterol, resulting in strokes, heart attacks, and death if not attended to before the tipping point.[9]

 

Sleep Conditions that Affect Heart Health

Unsurprisingly, poor sleep and lack of sleep aren’t the only sleep-related factors affecting heart health. As with the nature of the risk factor, a growing body of research suggests a correlation between various sleep disorders and heart health.[10]

Sleep apnea, a condition in which the airway becomes obstructed during sleep, which consequently stops you from breathing for short bursts of time, can be caused by and be a cause of CVD risk factors, such as diabetes, heart disease, high blood pressure, and high cholesterol levels.[11]

Another common sleep condition, insomnia, affects around half of all adults at some point. Insomnia can lead to increased blood pressure, heart disease, and the adoption of unhealthy habits that lead you to choose less healthy foods and become less physically active.[12][13]

 

SCOFA-Irregular-Sleep-and-Heart-Disease-2

 

How Much Sleep Do You Need?

Sleep and mortality are associated in a U-shaped fashion whereby those getting significantly less or more than 7-to-8 hours of sleep per night are at a higher risk of mortality.14 Though the exact mechanism behind this pattern has to be pinpointed, evidence has constantly repeated the importance of getting 7-to-8 hours of sleep per night.[15]

 

Improving Sleep to Protect Heart Health

Several sleep experts and regulatory bodies, such as the CDC, have provided us with steps to improve our sleep and protect our heart health. These can be categorized into three subsections.[13]

1) Lifestyle changes

Lifestyle factors are the easiest to implement and arguably the most important. Though these factors differ between individuals, the below advice can be considered gold-standard for all.

This factor means going to bed and waking up at the same time every day, even on weekends, to regulate your body’s internal clock, making it easier to fall and stay asleep.[16]

  • Create a Relaxing Sleep Environment

Keeping your bedroom cool, dark, and quiet and avoiding stimulating activities, such as watching TV or using electronic devices, in the hours leading up to bedtime can help emulate a peaceful night’s sleep. Instead, you can try relaxing activities, such as reading or taking a warm bath, to help you wind down.[16]

2) Medical Interventions

Certain sleep conditions warrant medical intervention for any improvement in symptoms to become apparent. For instance, continuous positive airway pressure (CPAP) machines are often used to treat sleep apnea.[17] By using a CPAP machine, individuals with sleep apnea can improve their sleep and reduce their risk of heart disease.[17]

Likewise, other sleep conditions may need to be initially treated using a class of medicines called hypnotics.[18] These medicines though addictive and indicated only for short-term use, can help individuals who have sleep-disrupting conditions until more efficient strategies are put in place.[18]

3) Psychosocial Therapy

In around half of the cases, poor quality of sleep and the inability to get a good night’s sleep is attributed to an underlying mental health condition.[19]

If your sleep problem has been linked to mental health, it’s recommended that you reach out to your healthcare provider so that an adequate management plan can be put in place.20 Psychosocial sleep therapy can include a combination of cognitive behavioral therapies, medication, and medicine to help you establish a healthy sleep routine.[20]

 

What’s the Takeaway?

The relationship between sleep and heart health is complex and multifaceted, but the effect of poor sleep on heart disease risk has been robustly implicated. As such, preventing and treating sleep disorders and ensuring both adults and children achieve adequate sleep duration becomes vital. We should look beyond the risk factor norm and instead look at newer and potentially preventable risk factors such as sleep to protect our hearts.

 

References:

  1. Bays, H. E., Kulkarni, A., German, C. A., Satish, P., Iluyomade, A., Dudum, R., Thakkar, A., Rifai, M. A., Quyyumi, A. A., Thobani, A., Al-Saiegh, Y., Nelson, A., Sheth, S., & Toth, P. P. (2022). Ten things to know about ten cardiovascular disease risk factors – 2022. American Journal of Preventive Cardiology, 10, 100342. https://doi.org/10.1016/j.ajpc.2022.100342 
  2. Korostovtseva, L., Bochkarev, M. N., & Sviryaev, Y. (2021). Sleep and Cardiovascular Risk. Sleep Medicine Clinics, 16(3), 485–497. https://doi.org/10.1016/j.jsmc.2021.05.001 
  3. Colten, H. R. (2006). Extent and Health Consequences of Chronic Sleep Loss and Sleep Disorders. Sleep Disorders and Sleep Deprivation – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK19961/ 
  4. Li, Y., Cao, G., Jing, W., Liu, J., & Liu, M. (2022). Global trends and regional differences in incidence and mortality of cardiovascular disease, 1990−2019: findings from 2019 global burden of disease study. European Journal of Preventive Cardiology. https://doi.org/10.1093/eurjpc/zwac285 
  5. Nagai, M., Kario, K., & Kario, K. (2009). Sleep Duration as a Risk Factor for Cardiovascular Disease- a Review of the Recent Literature. Current Cardiology Reviews, 6(1), 54–61. https://doi.org/10.2174/157340310790231635 
  6. Sharma, S., & Kavuru, M. S. (2010). Sleep and Metabolism: An Overview. International Journal of Endocrinology, 2010, 1–12. https://doi.org/10.1155/2010/270832 
  7. Gottlieb, D. J., Punjabi, N. M., Newman, A., Resnick, H. E., Redline, S., Baldwin, C. M., & Nieto, F. J. (2005). Association of Sleep Time With Diabetes Mellitus and Impaired Glucose Tolerance. Archives of Internal Medicine, 165(8), 863. https://doi.org/10.1001/archinte.165.8.863 
  8. Motivala, S. J. (2011b). Sleep and Inflammation: Psychoneuroimmunology in the Context of Cardiovascular Disease. Annals of Behavioral Medicine, 42(2), 141–152. https://doi.org/10.1007/s12160-011-9280-2 
  9. Chung, W. A., Lin, C., Chen, Y., Chiang, J. Y., Sung, F., Chang, Y., & Kao, C. (2013). Sleep Disorders and Increased Risk of Subsequent Acute Coronary Syndrome in Individuals without Sleep Apnea: A Nationwide Population-Based Cohort Study. Sleep, 36(12), 1963–1968. https://doi.org/10.5665/sleep.3240 
  10. Grandner, M. A., Alfonso-Miller, P., Fernandez-Mendoza, J., Shetty, S., Shenoy, S., & Combs, D. (2016). Sleep. Current Opinion in Cardiology, 31(5), 551–565. https://doi.org/10.1097/hco.0000000000000324 
  11.  Tietjens, J. R., Claman, D. M., Kezirian, E. J., De Marco, T., Mirzayan, A., Sadroonri, B., Goldberg, A. V., Long, C. S., Gerstenfeld, E. P., & Yeghiazarians, Y. (2019). Obstructive Sleep Apnea in Cardiovascular Disease: A Review of the Literature and Proposed Multidisciplinary Clinical Management Strategy. Journal of the American Heart Association, 8(1). https://doi.org/10.1161/jaha.118.010440 
  12. Javaheri, S., & Redline, S. (2017). Insomnia and Risk of Cardiovascular Disease. Chest, 152(2), 435–444. https://doi.org/10.1016/j.chest.2017.01.026 
  13. How Does Sleep Affect Your Heart Health? | cdc.gov. (2021, January 4). Centers for Disease Control and Prevention. https://www.cdc.gov/bloodpressure/sleep.htm#:~:text=Insomnia%20is%20linked%20to%20high,especially%20earlier%20in%20the%20day. 
  14. Grandner, M. A., Hale, L., Moore, M., & Patel, N. (2010b). Mortality associated with short sleep duration: The evidence, the possible mechanisms, and the future. Sleep Medicine Reviews, 14(3), 191–203. https://doi.org/10.1016/j.smrv.2009.07.006 
  15. Watson, N. F., Badr, M. S., Belenky, G., Bliwise, D. L., Buxton, O. M., Buysse, D. J., Dinges, D. F., Gangwisch, J. E., Grandner, M. A., Kushida, C. A., Malhotra, R., Martin, J. H., Patel, S. R., Quan, S. F., Tasali, E., Twery, M. J., Croft, J. B., Maher, E., Barrett, J. A., . . . Heald, J. L. (2015). Recommended Amount of Sleep for a Healthy Adult: A Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society. Sleep. https://doi.org/10.5665/sleep.4716
  16. Good Sleep Habits. (2022, September 13). Centers for Disease Control and Prevention. https://www.cdc.gov/sleep/about_sleep/sleep_hygiene.html 
  17. Jean-Louis, G., Brown, C. D., Zizi, F., Ogedegbe, G., Boutin-Foster, C., Gorga, J., & McFarlane, S. I. (2010). Cardiovascular disease risk reduction with sleep apnea treatment. Expert Review of Cardiovascular Therapy, 8(7), 995–1005. https://doi.org/10.1586/erc.10.55 
  18. Lie, J. D. (2015, November 1). Pharmacological Treatment of Insomnia. PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4634348/ 
  19. Sleep Disorders | NAMI: National Alliance on Mental Illness. (n.d.). https://www.nami.org/About-Mental-Illness/Common-with-Mental-Illness/Sleep-Disorders#:~:text=Approximately%2050%25%20of%20insomnia%20cases,a%20person’s%20inability%20to%20sleep.
  20. Riemann, D., & Espie, C. A. (2018). Evidence-based psychological therapies for insomnia. The Lancet, 392(10149), 735. https://doi.org/10.1016/s0140-6736(18)31819-1 
SCOFA - Find Sleep Medicine Professionals & Services