Beating insomnia for a healthier heart: How improving sleep quality can lower risk

Sleep really is a lifesaver.

A pair of studies released this week at a leading cardiology conference found that while insomnia may raise the risk of having a heart attack, consistent high quality sleep habits could add years to your life.

People with insomnia are 69% more likely to have a heart attack, compared to those who do not have the sleep disorder, according to a new analysis of previous research presented Friday at the American College of Cardiology’s annual conference.

The study conducted by an international team of researchers examined the connection between insomnia and heart attacks through data on more than 1 million adults, average age 52, from six countries. People were categorized as having insomnia if they had at least one of three symptoms:

• Difficulty falling asleep.
• Difficulty staying asleep.
• Waking too early in the morning.

The symptoms had to be present for at least three days a week for at least three months. Over an average of nine years of follow-up, people who habitually slept five or fewer hours were 56% more likely to have a heart attack than those who had the recommended eight hours a night, regardless of age or gender.

The researchers hope the study will raise “awareness of the importance of sleep in maintaining a healthy heart,” said the study’s first author, Yomna E. Dean, a medical student at Alexandria University in Alexandria, Egypt.

“Many people don’t realize how important it is,” Dean said.

“Some people might not necessarily be insomniacs, but are sleep deprived by choice,” Dean added. “That’s common nowadays. These findings apply to everyone who sleeps five or fewer hours a night.”

An estimated 10% of Americans have some form of insomnia and it’s more common in women, said Dr. Sanjay Patel, director of the Center for Sleep and Cardiovascular Outcomes Research at the University of Pittsburgh.

“At least part of the reason for that may be that two of the most common risk factors for insomnia are anxiety and depression, which are both more common in women,” said Patel.

A second study presented at the meeting focused on the quality of sleep. Researchers found that good sleep habits can benefit the heart and overall health, and even life expectancy. They also found that 8% of deaths from any cause could be linked to poor sleeping patterns.

People with highest quality sleep lived longer, according to the study: 4.7 additional years for men and 2.4 years, for women.

Stress is often the root of short bouts of insomnia, Patel said. In some people, that short-term stress “takes on a life of its own,” he noted. “Then, the not sleeping becomes the new stress. The more you worry about it, the harder it is to fall asleep. I’m a little concerned that this study might worsen insomnia for some people who will worry that if they can’t get more sleep they are going to have a heart attack.”

How to improve sleep

Patel’s suggestions include:

• Make sure the bedroom environment is comfortable and quite dark.
• Avoid any chemicals that will stimulate your brain. Caffeine should be avoided for at least eight hours before bedtime. Nicotine and tobacco products should also be avoided. “You want to find things that will help you relax, instead,” said Patel.
• Avoid looking at a clock. “Seeing what time it is gets people even more stressed that they’re not sleeping,” said Patel. “We want people to do things that distract the brain and maybe even make them somewhat bored.”
• Read a book or play a mindless game on the computer. Knitting or listening to music can help the transition to sleep.
• Avoid naps. Clinical trials have shown that some sleep deprivation in the short term can help improve sleep. “No matter how poorly you’ve slept, you want to force yourself to get up and you want to avoid naps during the day,” said Patel. “You will be training your brain to recognize that if it doesn’t sleep during the time you’ve given it, it won’t get any more sleep.
• Get lots of sunlight. You can start working on your sleep first thing in the morning by making sure you’re exposed to sunlight, which helps calibrate your biological clock. “Go outside and walk,” said Rebecca Robbins, an instructor in medicine at the Harvard Medical School and an associate sleep scientist at Brigham and Women’s Hospital in Boston. “If you’re taking the subway, walk to a stop beyond the one you usually take. You want to build tiny habits into routines.”
• Focus on getting relaxed before bed. “You might want to take a warm shower,” Robbins said. “If you can’t stop thinking about what’s coming tomorrow, write down a list of dos so you can get them out of your head.”

It’s important to develop rituals that your brain will associate with falling asleep, Robbins said, adding “it could be reading a book or thinking one happy thought or meditating.”

If you wake up during the night, go back to the same set of rituals that got you to sleep earlier on, Robbins said.

If you can’t sleep don’t just lay in bed, Robbins said.

“You want to keep your bed as a place for sleep and sleep alone,” Robbins said. “If you’re tossing and turning get out of bed. Bed should be the safe place you sleep.”