Insufficient Or Poor Quality Sleep And Cardiovascular Risk
Sleep is an essential component of good physical and mental health. However, the average sleep duration in the Western world has steadily declined over the past decade. In the National Health Interview Survey 2004 to 2007, more than one third of the North American adult population was noted to have an abnormal duration of sleep, defined as too short or too long . Previous laboratory and epidemiologic studies showed that inadequate sleep patterns, in terms of both quality and quantity, are associated with an increased frequency of cardiovascular risk factors such as hypertension, diabetes mellitus, and obesity, as well as independently associated with an increased risk of adverse cardiovascular outcomes, such as stroke and myocardial infarction. A meta-analysis of 16 prospective cohort studies reported a significant association between sleep of short duration and long duration and an increased risk of all cause-mortality. Therefore, insufficient or poor-quality sleep is a common risk factor for cardiovascular disease and all-cause mortality, and represents a potentially important population-based modifiable target for CVD prevention.
The Connection Between Stress And High Blood Pressure
Stress has significant effects on the body and your blood pressure. The rush of adrenaline that comes from a stressful situation produces a sudden surge of hormones that cause your heart to beat faster. This also impacts your blood vessels, causing them to narrow in response and increase pressure on your arteries.
Its all interconnected. Sleep is a big way our body is able to respond and manage stress. When you sleep well, you can better manage your stress and thus reduce your hearts strain. When you stress less, you can sleep better. Either way, your health improves, which is why its so important to take an inventory of your life and make adjustments quickly when you begin noticing trouble in either area.
Symptoms Of Stress And Their Impact On Sleep
Stress doesnt always show itself right away. It may start slowly and quietly, revealing itself as a headache, upset stomach, or just good, old-fashioned fatigue. Your mental health can become affected as depression and anxiety begin to take over. All of that stress starts to build up over time until suddenly, theres no ignoring it anymore. Often, your sleep can be the biggest victim.
Sleep is a chance for the body to rest and regenerate, recharging for the next day to come. Our bodies are only able to survive so long without the opportunity for rest, and a lack of sleep can significantly impair the bodys systems and the way they can work together to keep the body going.
Stress has long been known as a significant deterrent to a healthy nights rest, and if left untreated, the body will slowly give way over time. It opens the door to other, more severe issues, like depression, weight gain, skin problems, decreased sex drive, and heart disease.
Thankfully, there are ways to help.
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Understanding How Sleep Affects Health And Mortality For New Underwriting Methods
Sleep is as universal as eating and breathing. We do it every day and it affects how long we live. Too little or even too much also affects our mental health, heart health and more. And our sleep is woven into a complicated web of lifestyle factors that play off one another for better or for worse. In addition, sleep interacts with traditional clinical risk factors like blood pressure and weight which in turn drive health and mortality.
The more we understand the underlying dynamics of these interactions, the better insurers can leverage sleep data. It’s a complex knot, but through our “Big Six” lifestyle research, we aim to unwind it enough to develop reliable criteria that can inform credible risk assessment and drive better health outcomes. As insurers work to streamline risk assessment, knowing how to factor these new data points into underwriting decisions will be essential. This research is just the beginning.
Could sleep data help us better understand cardiovascular risk? Could other lifestyle factors such as physical activity be a proxy for the quality of someone’s sleep?
What Causes High Blood Pressure At Night
While poor sleep is associated with higher blood pressure and blood pressure spikes, it goes the other way too: people with high blood pressure may be more prone to chronic anxiety, which can in turn play a role in poor sleep. Thats why Im so serious about treating not just the body but also the mind, and urge clients to get their racing thoughts under control by using a scientifically designed cooling headband like Ebb Precision Cool to relax at night.
But having high blood pressure only at night, or experiencing high blood pressure spikes at night could point to something more specific. High blood pressure at night, many experts believe, points to signs of a specific sleep disorder.
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Sleep Plays An Important Role In Heart Health
Theres more to staying heart-healthy than just eating right and exercising regularly, namely getting enough shuteye. Indeed, sleep plays an important role in overall health and well-being. By the same token, healthy diet, regular exercise and low stress may promote the sort of deep, restorative sleep that is essential for good cardiovascular health.How much sleep do you need? The Centers for Disease Control and Prevention in Atlanta advises adults between 18 and 65 to aim for at least seven hours of good quality sleep per night. Unfortunately, sleeping well is not the necessarily the norm. In fact, according to the National Heart, Lung, and Blood Institute of the National Institutes of Health, 50 million to 70 million American adults either dont get any sleep on a regular basis or have a sleeping disorder.
How Much Sleep Do I Need
Most adults need at least 7 hours of sleep each night.1 However, more than 1 in 3 American adults say they dont get the recommended amount of sleep.2 While this may be fine for a day or two, not getting enough sleep over time can lead to serious health problemsand make certain health problems worse.
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Pay Attention To Your Diet
Some people are very sensitive to salt, and that causes a rise in blood pressure, likely due to fluid retention,” Besser says. Aim for no more than 2,300 milligrams of sodium a day, paying particular attention to packaged foods and meals prepared outside the home.
Additionally, Besser recommends a diet lower in cholesterol, carbohydrates, and processed foods. Instead, focus on eating vegetables, fruit, whole grains, lean meat , nuts, beans and legumes, and olive oil.
Choice Of Study Population
Our study is a Phase II trial. A primary prevention population of participants with no previous CVD and poor sleep quality has been chosen because of the high likelihood of such participants being responsive to the intervention and demonstrating a reduction in blood pressure with the intervention. Potential participants already receiving antihypertensive medications are eligible for inclusion in the trial. However, participants with diabetes mellitus and chronic renal impairment are excluded, which should reduce the proportion of participants that will have changes to their blood-pressure medications over the course of the trial.
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Treating Sleep Disorders To Improve Blood Pressure Control And Cardiovascular Prevention: A Dream Come Truea Narrative Review
Giuseppe Maiolino1, Valeria Bisogni2, Alessandro Silvani3, Martino Francesco Pengo4, Carolina Lombardi4,5, Gianfranco Parati4,5
1Clinica Medica 3, Department of Medicine – DIMED, University of Padova 3Department of Biomedical and Neuromotor Sciences, University of Bologna 4IRCCS Istituto Auxologico Italiano, Department of Cardiovascular, Neural and Metabolic Sciences, Milan , Italy
Contributions: Conception and design: None Administrative support: None Provision of study materials or patients: None Collection and assembly of data: None Data analysis and interpretation: None Manuscript writing: All authors Final approval of manuscript: All authors.
Correspondence to:
Keywords: Sleep disorders hypertension nocturnal blood pressure therapy
Submitted Jul 07, 2020. Accepted for publication Sep 10, 2020.
doi: 10.21037/jtd-cus-2020-014
How To Sleep Better With Low Blood Pressure
This article was written by Dr. Babar Naeem a licensed and practicing medical doctor to ensure maximum factual accuracy and unique content.
Low blood pressure can be caused by multiple factors, including decreased fluid intake, vitamin B deficiency, dehydration, drugs, pregnancy, heart disease, hormonal imbalance, kidney disease, anemia, and septicemia.
Symptoms of low blood pressure include dizziness, headaches, vertigo, pale skin, sweating, irregular heartbeat, blurred vision, and fainting which may make it difficult to get to sleep.
So how can you sleep better when you have low blood pressure?
The most effective way to sleep better with low blood pressure is to elevate your legs using pillows or the lower section of an adjustable bed. Drinking more water and increasing vitamin B12 and folate intake whilst avoiding medications that lower blood pressure can also help.
However, you should always consult with your own doctor for the best treatment of your low blood pressure.
You should also talk to them about managing your low blood pressure for better sleep.
The rest of this article expands upon the points above using the knowledge I have gained as a practicing medical doctor.
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A Few Things To Know About Sleep And Your Health
Youve gone in for your routine physical examination, and youre told what millions of Americans have already been told: You have high blood pressure. But, like many Americans, you may not be aware of the truth behind the powerful connection between blood pressure spikes and the quality of your sleep.
The truth is that lack of sleep can cause high blood pressure sleep apnea may play a role and you should know what might be behind a sudden spike of high blood pressure at night.
How Dangerous Is High Blood Pressure?
High blood pressure, also known as hypertension, is classified as Stage One or Stage Two. Stage One hypertension is a reading of 130/80 mm Hg or above, while Stage Two has readings of 140/90 mm Hg or above. Anything exceeding 180/120mm is considered a medical emergency.
If youve been diagnosed with hypertension, or youve just experienced a sudden spike in blood pressure, youre far from alone. In fact, according to the CDC, 45 percent of adults in the United States experience high blood pressure, and only a quarter of those have their blood pressure properly being treated.
Blood pressure can have a dramatic impact on your health, especially if you have chronic hypertensionbut even sudden spikes in high blood pressure can contribute to the following.
Can Lack of Sleep Cause High Blood Pressure?
Mechanism Underlying The Association Between Poor Sleep And Hypertension
The mechanism underlying the association between insufficient or poor-quality sleep and hypertension is proposed to be multifactorial, including increased sympathetic nervous system activity and increased prevalence of intermediate risk factors, such as poor diet, reduced physical activity, increased weight, and smoking. Laboratory studies have noted significantly increased sympathetic activity and blood pressure in individuals in a sleep-restricted condition, compared with individuals in a sleep-recovery condition. Increased urinary excretion of noradrenaline, indicating increased sympathetic activity, has also been reported after a night of sleep deprivation. Increased activity of the sympathetic nervous system can lead to vasoconstriction as well as fluid retention, which can lead to hypertension through volume overload.
Blood pressure and heart rate typically exhibit diurnal variation. During sleep, a nocturnal dip occurs in both blood pressure and heart rate, which remain low until the time of awakening. Reduced sleep duration can result in longer exposure to enhanced sympathetic activity and increased average 24-hour blood pressure and heart rate. In this way, habitual sleep restriction can lead to prolonged enhanced sympathetic nervous system activity, the development of hypertension, and subsequently, an increased risk of stroke and other CVD.
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Try Meditation Or Yoga
Mindfulness and meditation, including transcendental meditation, have long been used and studied as methods to reduce stress.
Yoga, which commonly involves breathing control, posture, and meditation techniques, can also be effective in reducing stress and blood pressure.
A 2013 review on yoga and blood pressure found an average blood pressure decrease of 3.62 mm Hg diastolic and 4.17 mm Hg systolic when compared with those who didnt exercise.
Studies of yoga practices that included breath control, postures, and meditation were nearly twice as effective as yoga practices that didnt include all three of these elements .
Osa And Prevalence Of Hypertension
OSA and hypertension commonly coexist. Approximately 50% of patients with OSA are hypertensive, and an estimated 30% to 40% of patients with hypertension have OSA.35–38 Cross-sectional studies have been consistent in demonstrating that moderate-severe OSA is significantly associated with risk of having arterial hypertension.37 In general, there is a linear relationship between AHI and prevalence and severity of hypertension, that is, the more severe the OSA, the higher the risk of hypertension of increasing severity.
In a study of 1,741 subjects aged 20 to 100 years, Bixler et al44 found that an AHI 15 was significantly associated with hypertension risk however, the strength of this association decreased with age. Another study of 2,148 subjects aged 30 to 70 years and with an AHI 15 had an OR for hypertension risk of 2.28 , after adjusting for confounders such as BMI, neck circumference, and alcohol use.45 In this analysis, an increase in the AHI of 5 events/h increased the risk of having hypertension by 1.25%. In the Sleep Heart Health Study, which included 6,123 subjects aged > 40 years, an AHI 30 compared with < 1.5 was associated with an OR for prevalent hypertension of 1.37 .46 These data demonstrate that the presence of moderate-severe OSA is positively related to both the prevalence and the severity of hypertension.
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Sleep And Type 2 Diabetes
Type 2 diabetes is a chronic condition in which the level of blood sugar, also known as blood glucose, is too high due to the bodys inability to process sugar properly. Excess blood glucose damages blood vessels, negatively affecting cardiovascular health. People with diabetes are twice as likely to die from heart disease or stroke than people without this condition.
Many factors affect blood sugar, but studies have found that a lack of sleep worsens glucose metabolism. Poor sleep is associated with prediabetes, a a type of glucose intolerance that does not meet the parameters for diabetes. People already diagnosed with diabetes who have insufficient or restless sleep may have a harder time controlling their blood sugar. Impaired sleep may also worsen the hardening of arteries in people with type 2 diabetes.
The Two Sides Of Sleep
Today our wearables and phones can tell us how long, and often how “well” we sleep. Sleep duration and lack of disturbance both impact sleep quality, which is largely driven by the time we spend in different sleep cycles, some which provide more restorative and physiological benefits than others.
Shorter sleep and fragmented sleep interrupt key biological pathways and mechanisms such as our endocrine functioning and over-activation of our autonomic nervous system. These negatively impact our immune function, blood pressure, inflammatory markers, and insulin resistance.
Just as poor sleep negatively impacts our health in many ways, a good sleep routine can improve health and longevity. Adequate sleep helps to strengthen our immune systems, lower blood pressure, decrease inflammation and even improve insulin sensitivity. The potential for improved sleep to ultimately improve health outcomes is encouraging for insurers and customers alike.
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All You Need To Know About Sleep And High Blood Pressure
Getting good sleep is not a luxury it is important for promoting good health. Most adults require at least eight hours of sleep a night to allow the body to repair itself and function normally. While a night or two of poor sleep may have little long-term effect, failure to get enough sleep over time may lead to serious health conditions or worsen existing ones.
Adults who get less than seven hours of sleep a night are prone to developing serious health conditions over time, such as depression, heart attack, and stroke. It is important to note that a constant lack of sleep can cause hypertension in people of all ages.
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How Does Sleep Affect Heart Health
Studies show short sleep duration or poor sleep quality, is associated with high blood pressure, elevated cholesterol and atherosclerosis. And habitual short sleep increases the chance of cardiovascular events. Not getting enough restful sleep is also correlated with:
Poor diet / weight gainA study of 495 participants found an association between poor sleep quality, increased food intake and lower consumption of whole grains. And short sleep duration may lead to weight gain, even in those with a low risk for obesity.
Diabetes An analysis of past studies suggests not getting enough Zs significantly increases the risk of developing Type 2 diabetes. In addition, losing as little as two hours of sleep per day may lead to increased insulin resistance and decreased glucose tolerance in lab conditions.High blood sugar associated with diabetes can also increase cholesterol, blood pressure and triglycerides, ultimately damaging the nerves and blood vessels. As a result, people with Type 2 diabetes are twice as likely to have a heart attack or stroke.
InflammationIn lab studies, sleep restriction is associated with inflammation, and preliminary research suggests this may be true in the general population. This is important because inflammatory processes can elevate risk for cardiovascular disease.
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