Sleep and Heart Disease

Sleep and Heart Disease

Thirteen to forty-four percent of patients with coronary heart disease report comorbid insomnia and population studies have shown that chronic sleep disturbance is associated with an increased risk of developing cardiovascular disease.

Most researchers believe that insomnia is linked to cardiovascular health in two different ways: (1) directly, through physical changes and (2) indirectly, through behavioral factors. Physical changes include increased blood pressure, appetite, inflammation, and other bodily stress reactions. Common behavioral factors are low mood, low motivation, and cognitive difficulties that can negatively impact decision-making about healthy behaviors.

Some sleep disturbance is a normal part of life. For example, child care, taking care of an acutely ill family member, and occasional stress-related insomnia are expected disturbances. Chronic sleep problems are those that occur most nights, or every night, for months to years.

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What to do

Fortunately, insomnia is treatable. Sleep medications can be helpful but mental and behavioral strategies are more long-lasting. First, identify your biggest problem: falling asleep, staying asleep, or waking up too early. Then learn how to change your behaviors to maximize sleep, manage your thoughts and worries that interfere with sleep, and change your mind-set about sleep. Behavioral sleep treatment can make you less vulnerable to the effects of poor sleep on the heart.

Here are some suggestions for managing insomnia and keeping your heart healthy:

Boost your consistency

Stick to a regular wake time. A regular bedtime helps too, but a regular wake time is the most important.

Avoid napping. Long naps can decrease sleep quality and increase nighttime wakefulness. If napping is necessary to help keep a regular wake time, nap for only 30 minutes about 7-9 hours after you wake up.

Build the link between being in bed and sleeping. Save the bed for sleep & sex only. Don't watch TV, talk on the phone, eat, drink, read, or work in bed.

Break the link between not sleeping and being in bed. If you're awake for more than 20 mins, get up and do something quiet and soothing, such as reading or listening to quiet music. Do not watch TV or use your computer.

Build the link between sleepiness and being in bed. Only return to bed when you feel sleepy again. If you think you feel sleepy and you return to bed – only to lie awake for another 20-30 minutes – then get up again. Repeat this behavior until sleep takes hold.

Learn to wind down Reading

Don't worry in bed. Set aside a specific "worry time" in the morning or late afternoon to rationally problem-solve.

Build in some "wind-down" time. Disengage from physically or mentally demanding tasks about 30 – 90 minutes before bedtime; begin to transition towards sleep by doing pleasant or soothing activities. Examples include:

Practice relaxation exercises to slow your mind and body down.

Challenge your own beliefs about sleep. Insomnia can lead to worries and fears about sleep, which can then maintain the insomnia. Practice balanced thinking and learn more about cognitive behavioral techniques. For more information, visit the Stanford Center for Sleep Sciences and Medicine.

Stanford Medicine Resources:

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