Heart Health Preventing Heart Problems

Sleep Soundly for Heart Health

What other sleep problems may be a factor?
Sleep apnea is a condition that is characterized by a collapse of the airway that occurs during sleep. When the airway collapses, eventually the person wakes up to resume breathing, and goes back to sleep and does it again. Obviously, if you have to wake up to breathe, you don't sleep very well.

There's substantial literature suggesting that the falls in oxygen and the elevations in carbon dioxide contribute to the development of heart disease. Sleep apnea clearly contributes to the development of high blood pressure, and it leads to the development of heart attacks, strokes and congestive heart failure as well.

How might sleeping too long be a factor in heart disease?
There have been at least three major studies of huge groups of people to look at the relationship between sleep duration and some of these outcomes, and they've all shown that if you sleep too long, you tend to get adverse outcomes. In some cases, the outcome was heart disease. In other cases, it was death. None of the studies have come up with a very good explanation, even in a speculative way.

The one explanation they commonly give is maybe these people have a sleep disorder such as sleep apnea, which causes them to spend more time in bed, and therefore they end up with a medical problem.

I don't personally find that very convincing because I follow lots of patients with sleep apnea and most of them just don't spend nine and 10 hours a day in bed trying to sleep. So it may turn out to be something to do with the effect of inflammatory systems on sleep.

How might inflammation play a role in sleep and heart disease?
There's a little bit of data that sleep deprivation can lead to increases in cytokines that may ultimately turn out to be important in cardiovascular disease. Cytokines are basically chemical mediators to help cells talk to cells. Normally cytokines attract other cells to the area to try to fight the inflammation, but when they start to attack normal tissues, they can have a damaging effect. There's some evolving evidence that inflammation may be important in the development of heart disease. If that's true, that may turn out to be very important.

How important is good sleep for heart health?
There's evolving evidence that getting a reasonable quantity of good quality sleep is important in maintaining health and particularly heart health. That's not to say that if you sleep fewer than six hours or you sleep more nine or more hours, it's going to be the overwhelming variable in the development of heart disease, but it will probably be a contributor along with a variety of other factors.

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