How does poor sleep affect the heart?

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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. Healthy­in­fo will talk about sleep dis­or­ders and their effect on the heart.

Insomnia and heart disease

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

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

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

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

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By Yraa

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