We spend a third of our lives sleeping. Sound healthy sleep is the key to a full recovery of the body after a hard day. Sleep disorders affect many systems of our body and, in particular, the cardiovascular system. It would seem that the heart works without breaks for sleep — how can the quality of the latter affect the activity of the heart muscle? But research shows that sleep and heart health are much more closely linked than you might expect. MedAboutMe will talk about sleep disorders and their effect on the heart.
Insomnia and heart disease
Almost every third adult suffers from insomnia to some extent. Someone tossing and turning for an hour, trying to fall asleep, and someone does not sleep at midnight, feeling in the morning as if he had not slept all his life. Doctors call insomnia the inability to sleep normally for at least three days a week for three or more months.
According to Chinese researchers at the Shenyang Medical University, insomnia increases the risk of developing cardiovascular disease (CVD) and stroke, with different aspects exacerbating the situation in different ways:
- problems with falling asleep increase the risk of CVD by 1.27 times compared with those who do not suffer from insomnia;
- inability to fall asleep during the night — 1.11 times;
sleep, after which a person does not feel rested — 1.18 times.
Insomnia affects women a little more than men, especially in terms of sleep, which does not give rest. This is due, in particular, to the fact that women in general, by nature, suffer from insomnia more often than men. However, the difference between the sexes is not very large.
Scientists explain the destructive effect of insomnia as follows. In this condition, there are malfunctions in the metabolic processes of the body, violations of its endocrine functions, the activity of the sympathetic nervous system increases (the one that innervates all the internal organs of a person, including the heart, of course), the level of blood pressure and the concentration of cytokines (substances involved in inflammation processes) increase. ). One study also showed that insomnia leads to an increase in the thickness of the intima-media complex (IMC) of the carotid arteries — translated from the language of ultrasound specialists, the media of the carotid arteries thickens, which increases the likelihood of developing atherosclerosis and coronary heart disease.
Every fourth patient with a mechanical heart valve faces an unusual problem. The implant is so noisy that it prevents a person from sleeping. And if 23% of patients suffer from its noise at night, then 9% cannot forget about it even during the day. Women are less likely to hear the sound of the valve, but are more annoyed about it than men. As a result, only half of patients manage to sleep normally with a mechanical valve in their heart, 31% sleep poorly, and 17% suffer from real insomnia. Moreover, earplugs in this case are absolutely useless — and even make the sound of the valve louder.
And it happens that it turns out to fall asleep right away, and a person sleeps, practically without waking up, but his sleep is still incomplete. Because he suffers from a variety of sleep breathing disorders.
Breathing disorders during sleep
There is also a feedback between sleep and the heart. So, in 70% of people with chronic heart failure (CHF) there is a violation of breathing during sleep. Moreover, only 2% of this category of patients pay attention to this and receive the necessary therapy. The rest prefer not to notice the problem. But in vain. Early recognition of the problem and timely action can improve cardiac output and reduce the risk of hospitalization and mortality. So, in another study, the quality of life of people with CHF was compared before and after they had already been to the hospital about this. It turned out that those who had problems with sleep were 2 times more likely to be hospitalized again with a relapse of the disease than those who were able to improve their sleep.
The high-risk group includes people who have survived percutaneous coronary intervention (PCI), that is, angioplasty — an operation during which a special catheter is used to clear an artery clogged with a thrombus and insert a stent tube into it, which does not allow it to narrow anymore. Among those who have undergone such an operation, 52% experience breathing problems during sleep. 21.4% of this group suffer from cardiovascular problems. And among those who have had surgery but sleep well, only 7.8% are at risk of getting heart or vascular disease.
Sleep apnea, a specific and rather dangerous condition in which the breathing of a sleeping person stops an average of 5 or more times per hour of sleep, should be included in a separate group among breathing disorders during sleep. With one of the varieties of this pathology — central sleep apnea syndrome — the brain incorrectly sends signals to the respiratory system, which leads to cyclic breath holding. People with central sleep apnea have a 2.58-fold increased risk of developing atrial fibrillation, and this risk increases with age. With one of the variations of central apnea — Cheyne-Stokes respiration — the probability of arrhythmia is 2.27 times higher than in people without this pathology.
However, the most common type of sleep disorder, obstructive sleep apnea, also poses a threat to the human heart, especially over the age of 75. Every 5 additional units of the apnea-hypopnea index (that is, every 5 extra breath-holds per hour) increases the risk of an episode of atrial fibrillation by 22%.
Sleep deficiency (lack of sleep) and the heart
Almost a third, more precisely, 29% of adults sleep less than 7 hours a day — it is this duration of sleep that is considered the “living wage” to maintain the health of not only the heart, but the whole body.
Experts from the American Heart Association (AHA) released the results of 16 years of observation of more than 1300 participants in the sleep research project (average age 49 years). A third of the subjects had the so-called metabolic syndrome — a combination of several risk factors at once, including an increased body mass index (more than 30 kg / m2), high levels of low-density lipoprotein cholesterol, fasting glucose and triglycerides, as well as hypertension. The presence of metabolic syndrome increased the risk of developing heart disease by 1.49 times — but this is only if a person slept more than 6 hours. If he slept little, less than 6 hours a day, then the probability of being hospitalized with a heart disease was already 2.1 times higher. That is, healthy sleep for at least 6 hours significantly reduced the risks even in the presence of metabolic syndrome.
Sleep and health
Doctors recommend valuing your sleep. Its value for heart health is no less than regular physical activity and proper nutrition (lots of fruits and vegetables, whole grains, lean meats and fish). Moreover, healthy food improves sleep.
Diseases such as type 2 diabetes and obesity exacerbate sleep and heart problems. Significant excess weight is an inevitable nocturnal shortness of breath, which in itself is harmful to the heart, and leads to serious sleep disturbances. Patients with these diagnoses need to be doubly attentive to their health and monitor the duration and quality of sleep.
People at risk of developing cardiovascular disease should pay special attention to the factors that affect the quality of sleep. Before going to bed, you should not drink alcohol and caffeinated drinks, any snacks should end 2–2.5 hours before going to bed, you should stop watching the news immediately before falling asleep and discussing world problems with your loved ones. No amount of overtime work should interfere with getting your required 7 hours of sleep daily.
By the way, no connection has been found between early awakening and heart problems, so larks are not at risk and can get up as early as they want — the main thing is that their sleep should be at least 7 hours.
But most importantly, if you have chronic sleep problems, you should be attentive to yourself, regularly undergo examinations by a cardiologist and check your health. And these problems cannot be ignored, it is necessary to look for ways to solve them. Otherwise, the heart is at risk.
Cardiology. National guide / ed. E. V. Shlyakhto - 2015
Neurology. National leadership. / Ed. E.I. Guseva, A.N. Konovalova, A.B. Hecht - 2014