The Effects of Lack of Sleep to our Heart Health: How to Sleep Better & Protect our Heart?

We all have experienced it – the headache, fatigue and sluggish feeling after a night of poor sleep. Often, we recover by turning in early the following night, or sleeping in over the weekend. But do you know that one hour of ‘sleep debt’ can not be sufficiently ‘paid back’ by one hour of extra sleep? Research shows that it may take up to 4 days to fully recover from 1 hour of sleep loss. And what happens if we regularly rack up sleep debt? Sleep studies confirm that frequent lack of quality sleep puts us at increased risk of developing heart and cardiovascular diseases. 

Getting sufficient sleep is therefore crucial for keeping our heart healthy, in addition to regular exercise, a healthy diet, and low stress. Loss of sleep affects our heart health in both direct and indirect ways. It can be a symptom of an underlying heart condition. It can increase the risks for heart disease, or cause other diseases like type 2 diabetes and obesity which worsen heart conditions. 

In this article, we will discuss the negative consequences of lack of sleep on cardiovascular health, how it causes different heart diseases, and how to sleep better and improve our overall heart health. 

1. Lack Of Sleep and Heart Health

The processes that are responsible for keeping our heart and blood vessels healthy are significantly influenced by sleep.

A typical night sleep progresses through 4 to 6 sleep cycles, depending on individuals. Each sleep cycle is made up of 4 stages of sleep, including 3 NREM (non-rapid eye movement) stages, followed by 1 REM (rapid eye movement) sleep stage. The third stage of NREM sleep and REM sleep are known as deep sleep. During these stages, our breathing rate goes down, blood pressure normalises, and heart rate slows. These changes remove stress from our heart so that it can recover from the strain that occurs during waking hours. 

Sleep deprivation prevents us from getting sufficient deep sleep each night, when our body repairs itself, heals the blood vessels in our heart and restores its functions. Among people with sleep disorders such as insomnia, sleep apnea, blood pressure is observed to be at elevated levels throughout the night and the following day, which may lead to hypertension over time. In addition to an increase in blood pressure, sleep also affects our inflammation level and blood sugar. If we do not get quality sleep, the risks increase for various cardiovascular problems such as hypertension, stroke, and coronary artery disease. 

2. Which Heart Conditions Are Associated With Lack Of Sleep?

Habitual short sleep and short sleep duration are associated with many cardiovascular events like atherosclerosis (narrowing and hardening of the arteries), coronary heart disease, high cholesterol, high blood pressure, heart failure, and stroke. Let’s have a look at insufficient sleep and its effects on different heart conditions. 

Sleep and Heart Rate

Our heart rate drops to 20-30% during the NREM deep sleep stages. It returns to normal when you wake up. Chronic sleep deprivation results in irregular and increased heartbeat and high blood pressure that puts extra pressure on our heart. Heart palpitations can also happen as a consequence of abrupt awakenings which are common among those with obstructive sleep apnea (OSA). 

Sleep and High Blood Pressure

Scientists observe a 10-20% drop in blood pressure during the normal NREM deep sleep stage, a phenomenon known as nocturnal dipping. Those with sleep disruptions and lack of sleep experience non-dipping, which means that their blood pressure does not drop during sleep. This increases the risk of high blood pressure, which may have serious consequences such as heart attack, stroke, coronary heart disease, or kidney failure, as we wrote about in our article about hypertension in Singapore and its complications here

Sleep and Heart Failure

Heart failure happens when the heart fails to pump and supply enough blood throughout the body, in many cases as a result of unmanaged hypertension. An observational study reported linkage between sleep deprivation and heart failure. This study also reported an increased risk of heart failure in those who sleep less than seven hours a day. The risk of heart failure was also found to be more common in people with unhealthy sleep behaviors like snoring, daytime sleepiness, and insomnia symptoms. 

Sleep and Atherosclerosis & Coronary Heart Disease

Coronary heart disease, also known as coronary artery disease, occurs when plaque builds up in the arteries, and restricts blood flow, a condition called atherosclerosis. Lack of sleep and sleep disruptions are believed to contribute to atherosclerosis, possibly due to chronic inflammation in the body. Atherosclerosis interferes with normal blood flow, causing coronary heart disease. In severe cases heart attack happens when a coronary artery is completely obstructed. Find out more about common heart diseases in Singapore and what causes them apart from loss of sleep in our in-depth blog post here

Sleep and Stroke

A stroke occurs when the brain cells die from the lack of oxygen because of obstructed blood flow to the brain. Studies have found a correlation between loss of sleep and stroke. Insufficient sleep increases the risk of stroke by elevating blood pressure and contributing to plaque buildup.  

3. Lack of Sleep & Other Diseases That Can Indirectly Worsen Heart Conditions

Lack of sleep is often correlated with several diseases that are linked with heart conditions. These disorders include:

Type 2 Diabetes

Studies have shown that lack of sleep causes type 2 diabetes because of insulin resistance. Our cardiovascular health is negatively influenced by excess blood glucose that causes damage to blood vessels. If you have type 2 diabetes, you are twice as likely to experience a stroke and heart disease. Also, lack of sleep causes the hardening of arteries in people with type 2 diabetes. 

Obesity

According to an analysis of existing research, loss of sleep has been reported to intertwine with obesity. People who sleep less than seven hours per night are found to be at higher risk of obesity. Lack of sleep also triggers the hunger hormone, prompting you to eat high-calorie foods at night, which in turn makes it harder to log peaceful hours of sleep. Obesity is a consistent risk factor for many heart complications, including stroke, heart attack, high cholesterol, hypertension, and heart failure. 

Inflammation

Substantial evidence has reported an association of sleep restriction with chronic inflammation. Scientists are still conducting research to better understand the exact mechanism. For now, they have established that the risk for cardiovascular diseases increases with inflammatory processes in the body due to sleep deprivation. 

4. Sleep Disorders & The Risk Of Heart Disease

By now, we have known that sleep deprivation puts our heart health at risk. Sleep disorders, for that reason, can exert detrimental effects on our cardiovascular health. Let’s look at 2 common sleep disorders – insomnia and obstructive sleep apnea – and how they can wreak havoc to the heart.

Insomnia

Insomnia affects 15.3% of the general public, and 13.7% adults above 60 years old in Singapore. However, many more are believed to suffer from insomnia without being diagnosed and treated. Research studies have shown linkage between insomnia, heart disease, and high blood pressure. Furthermore, individuals suffering from insomnia may also experience a surge in certain chemicals that affect their appetite, such as ghrelin which makes them crave for sugar and fatty food, and leptin which makes it harder to tell if they are full. Over time, they tend to adopt unhealthy habits that are not good for heart health, including poor dietary choices and physical inactivity. Insomnia may also lead to poorer concentration, negatively affecting school or work performance. This adds on to stress levels, further aggravating the risk of heart disease. 

To learn more about insomnia, its causes and treatment, check out our article on insomnia and how to sleep better here.

Sleep Apnea

Sleep apnea, and most commonly obstructive sleep apnea (OSA), is a sleep disorder in which a person’s airways get blocked during sleep, resulting in short breathing for short intervals. Like insomnia, sleep apnea has also been associated with different heart complications, including stroke, obesity, heart failure, and high blood pressure. The impact of sleep apnea on cardiovascular health worsens with disturbed respiration which reduces the amount of oxygen in the blood. 

5. Five Ways To Improve Sleep Quality And Heart Health

As sleep is associated with the body’s healing and restoring abilities, it is crucial for keeping our heart safe. Improving sleep quality is crucial to improving our heart health. However, this is known to be easier said than done. We all have been there, lying in bed trying to sleep and unable to do so. 

If you or your loved one have been struggling to get quality shut-eye time without success for a while, seeking medical help is recommended. Lack of sleep can be either a cause and a consequence of another medical condition. With a professional’s help, you will be able to check and treat any underlying medical causes that prevent you from getting a peaceful night’s sleep. In the case of primary insomnia (lack of sleep without an underlying cause), you may benefit from prescribed medications to help transit to a better sleep routine. 

However, medications for sleep may have their limitations, such as dependency, and reduced effect over time. Therefore, lifestyle changes at home are essential to improve sleep quality and quantity in the long-term. Below are some good lifestyle choices and sleep hygiene habits that are good for our slumber, which also means they are good for our heart:

Observe Symptoms Of Possible Sleep Disorders

Underlying sleep disorders like sleep apnea or daytime sleepiness can be the cause of poor sleep quality. Look into symptoms such as waking up tired even after sleeping for eight hours, snoring, struggling to stay awake in a meeting or while driving, and waking up from sleep multiple times a night. If you observe these symptoms, it is important to consult your GP or healthcare provider to identify the medical causes and address them effectively.

Improve Sleep Environment

A sleep-inducing environment contributes to a good night’s sleep. Electronics, extra lights, unwanted noise, late-night TV are among the public enemies of sleep. Bedroom should be sufficiently dark and at a comfortable temperature. Changing to fresh bed linens and pillow covers regularly can also help you sleep better. Also, you should only go to the bedroom to sleep when you are tired. Using the bedroom to work or lying in bed to watch TV can make the brain disassociate the sleep environment with sleep, making it harder for you to fall asleep when you want to.

Have A Consistent Pre-Sleep Routine

Going to bed and waking up at the same time sets the body clock, helping you to fall and stay asleep better. Pre-sleep routine also includes activities to prime the body and brain for sleep, such as changing from work clothes to loose and comfortable sleepwear. Other helpful habits are reading a book for 30 minutes, listening to relaxing music, and taking a bath before bedtime. 

Some people report having a glass of wine before bedtime helps them sleep better. This is not proven by research. Alcohol has sedative quality and may help you fall asleep faster, but it is believed to disrupt sleep quality later in the night. Caffeine is another sleep disruptor to avoid. If you want to fall asleep by 10pm, stop having coffee by 2pm the same day.

Exercise More

Regular exercise and physical activities during the day not only keeps our heart strong but also helps you fall asleep and stay asleep. 20-30 minutes of physical activity is recommended daily to boost sleep quality. However, avoid strenuous exercise late in the evening as it can take time for the body to switch to the relaxing state it needs before falling into sleep mode. 

Heart patients can also exercise by performing relaxing activities such as light stretching, yoga, meditation or deep breathing. Check out our recommended exercises for adults with cardiovascular conditions here.   

Cut Down on Stimulants

Caffeine, nicotine and alcohol are known to be sleep disruptors. Alcohol may help you fall asleep quickly but it prevents you from entering the stage of deep sleep at night. Cut down or avoid them altogether for better quality sleep.

Understand That Heart Health And Sleep Work Both Ways

If you are suffering from an underlying heart condition and undergoing treatment, you might experience disturbances in your sleep. For example, heart failure can worsen sleep quality because of pain and difficulty lying flat. Certain medications such as those for high blood pressure may cause sleeplessness. Similarly, if you are sleep deprived, the risk of developing or deteriorating cardiovascular disease increases. 

It is important to consult a medical professional about your sleep problems to understand the causal effect between sleep and heart condition and address both. 

Ninkatec Infographic_5 ways to improve sleep quality

5 ways to improve sleep quality

6. Takeaway Message

We hope the article highlights the connection between sleep problems and an increase in the risk for various heart diseases. By improving our sleep quality, we can protect our heart health, reducing our risk factors for high blood pressure, coronary heart disease, heart failure, stroke, among other chronic conditions. As there is no silver bullet solution, improving our sleep routine can be achieved by getting necessary medical help and making lifestyle modifications at the same time. 

At Ninkatec, we provide medical supervision and consultation to those who experience sleep problems and want to address them. Using medical technology such as ECG continuous monitoring during sleep, we are able to identify heart issues related to sleep patterns. Our advanced monitoring device is a small wireless patch which can be conveniently attached to your chest throughout the day including during your sleep. It works as effectively as usual traditional cumbersome ECG and sleep monitoring equipment. Furthermore, all the monitoring can be done in the comfort of your home, saving you the hassle of spending nights in unfamiliar sleep clinics. 

Reach out to Ninkatec Care Team via call, WhatsApp, email or leave a message at the form below for a private consultation if you experience any sleep and/or heart problems. Alternatively, visit our GP partners for an in-clinic consultation of the same:

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