Heart Disease and Sleep

Heart disease is a catch-all term for several heart conditions, including the most common kind, coronary heart disease. Left untreated, it can lead to heart attacks, and one in four deaths in America every year are caused by heart disease. According to the CDC, nearly half of Americans have at least one of the three risk factors for developing this condition: high blood pressure, high cholesterol, and smoking.

Another key risk factor is sleep deprivation. Not getting enough sleep increases your risk for high blood pressure, obesity, and type 2 diabetes, all of which are risk factors for heart disease. Additionally, sleep apnea (which is linked to obesity and other conditions, including heart failure) and insomnia increase your risk for high blood pressure and heart attacks.

What is Heart Disease?

Statistically, heart disease is very common, being the number one cause of death worldwide according to the World Health Organization. This is partly because it’s made up of many kinds of cardiovascular diseases and heart conditions that fall under this label. They range from conditions that lead to blocked blood vessels, to issues with arteries, to chronic heart failure and defects in the heart.

Some are congenital, which means people are born with an abnormality or defect that affects their heart. Others, however, develop later in life. While some are linked to other health conditions, many largely depend on people’s lifestyle, behaviors, and habits. In fact, the WHO reports that most heart diseases can be prevented with good habits that cut down on risk factors.

These risk factors are a combination of both habits and health conditions. According to the CDC, the top risk factors for non-congenital heart diseases overall are high blood pressure, high cholesterol, diabetes, obesity, poor diet, a sedentary lifestyle, smoking, and excessive alcohol use. This means cutting down on both risky lifestyle habits, as well as those that lead to health conditions which are risk factors, can both go a long way in preventing heart disease.

Types of Heart Disease

As we mentioned above, heart disease actually isn’t just one condition. Instead, it’s a broader label that includes a variety of cardiovascular diseases and heart conditions that vary in their severity, symptoms, and underlying causes. In this section, we’ll break down five of the most common.

Risk Factors of Heart Disease

Because heart disease is so common, there are many different factors that can increase your risk for the conditions grouped under the label. As we mentioned above, these are caused by both genetics and lifestyle habits, as well as other sorts of health conditions that have risk factors of their own. There are so many of these risk factors that nearly half of all Americans have at least one.

Aside from congenital heart defects, there are several risk factors for heart disease that people can’t control. These are age, gender, race/ethnicity, and family history. First, people’s risk for heart disease increases with age, so men older than 45 and women older than 55 have a greater chance of developing these conditions. Secondly, gender-specific health conditions can raise or lower people’s risk, with MedlinePlus citing higher estrogen levels (decreasing risk) and diabetes (increasing risk) in women as examples. Third, race plays a factor as African Americans are at higher risk than Caucasians for heart disease, while Latin Americans are at lower risk. Finally, people with early-onset heart disease in their family history are at greater risk for developing these conditions as well.

As for risk factors that people can control, MedlinePlus lists unhealthy weights and diets, lack of exercise, excessive alcohol consumption, smoking cigarettes, unmanaged stress, and lack of sleep. Changing your habits and behaviors to eliminate or control these factors will lower your risk not just for heart disease, but also for the health conditions that are themselves risk factors for heart disease. These include high blood pressure, diabetes, and high cholesterol.

Diagnosis & Prevention

For some people, developing heart disease is entirely out of their control. Others, however, can do several things to either prevent the condition or make it less severe. Part of this involves getting a diagnosis as soon as symptoms appear. If you are at greater risk, show symptoms, or simply have concerns about developing heart disease, there are a variety of tests you can take. They range from taking pictures of your heart, to looking at your arteries, to recording your heart activity, and can range from being quite invasive and painful to completely painless. MedlinePlus has a full list here, and you should sit down with your doctor to decide which one is the best for you.

Aside from securing a solid diagnosis, you can also start making changes to your lifestyle now to cut down on your risk for heart disease.

  • Diet: To prevent high cholesterol levels, the CDC suggests eating foods that are high in fiber and low in satured fats, trans fat, and cholesterol. To lower your blood pressure, it suggests cutting down on salt, while limiting sugar will help you control diabetes.
  • Activity: Getting enough exercise will help you manage your weight and lower your blood pressure, cholesterol, and blood sugar levels. Therefore, you should get 2.5 hours of “moderate” exercise weekly if you’re an adult, and 1 hour of physical activity every day if you’re a child or adolescent.
  • Stress Management: The American Heart Association says that high stress can increase your risk factors for coronary heart diseases and stroke, as well as lead to behaviors like overeating and smoking that will only compound your risk. Meditation, going for a walk, counting before speaking, sleeping, working out, and compartmentalization are all just a few possible steps for stress management, and the AHA hasfull lists here and here.
  • Substance Use: Smoking and drinking alcohol can increase your risk for heart disease, so both the AHA and the CDC recommend cutting down on your consumption or stopping entirely.

How Sleep Affects Heart Disease

One major lifestyle change you can make to cut down on your risk for heart disease is getting a consistently good night’s sleep. Part of this means treating any issues with insomnia, a medical condition in which someone has trouble falling or staying asleep. According to expert analysis by the American College of Cardiology, insomnia is a problem for around 10 - 15% of the U.S. population and this percentage jumps to 44% among people who have heart disease. Meanwhile, other studies have shown that sleep deprivation is linked to hypertension (HT), coronary heart disease (CHD), and diabetes.

This relationship between heart disease and sleep deprivation goes the other way, as well. As we just discussed, insomnia is almost three to four times as prevalent in people who have heart disease than the general U.S. population. This could be because certain heart conditions and heart disease symptoms actually make it hard for people to fall or stay asleep. According to an article published by Saint Francis Healthcare in Wilmington, Delaware, heart failure, angina, chest pain, heart palpitations, and trouble breathing all make it hard to get a good night’s sleep. For example, heart palpitations can jolt you awake from deep sleep, while conditions like heart failure can disrupt your breathing while you’re asleep. This is why it’s important to get these underlying conditions diagnosed and treated as soon as possible so that you don’t end up with a vicious cycle of sleep deprivation and heart disease.

Sleep Apnea and Heart Disease

Another major sleep condition that is linked to heart disease is sleep apnea. People with sleep apnea stop breathing during sleep, and there are three types: obstructive sleep apnea, central sleep apnea, and complex sleep apnea. If you have obstructive sleep apnea, your airway gets blocked while you’re asleep, and if you have central sleep apnea, your brain doesn’t send your body the signals it needs to keep breathing. Complex sleep apnea means you have a combination of the two.

As you may imagine, this can put a strain on your heart, as sleep apnea may be associated with irregular heartbeat, high blood pressure, heart attack, and stroke.  As with insomnia, people with heart disease are more likely to have sleep apnea than the general population. According to Harvard Medical School, 47% to 83% of people with heart disease and 12% to 53% of people with heart failure, atrial fibrillation, and stroke have the sleep disorder. If left untreated, it can raise your risk of dying from heart disease up to five times. Meanwhile, the condition increases your risk of having a heart attack by 30 percent over 4 to 5 years, and can increase your risk for developing type 2 diabetes, a major risk factor for heart disease, as well.

This means you should get diagnosed and treated as soon as possible if you think you might have sleep apnea, or if you’re from a population that’s at higher risk for developing the disorder. According to the American Heart Association, one in five adults has at least mild sleep apnea, and your risk for developing the disorder depends on factors like your age, gender, lifestyle habits, genetics, and ethnicity. Older adults, younger men, drinkers, smokers, overweight and obese people, people with a family history of sleep apnea, African-Americans, Latin Americans, and Native Americans are all more at risk for developing sleep apnea.

Sleep Tips for Managing Heart Disease

Because sleep deprivation is a major risk factor not just for heart disease but the health conditions that can increase your risk for it, it’s important to maintain healthy sleep habits and get a good night’s sleep. For the majority of adults, the CDC suggests getting at least 7 hours of shut-eye per night. This lowers your blood pressure, improves your ability to control your blood sugar levels, and helps keep you at a healthy weight. As for how to achieve and maintain this, the CDC lists the following as possible tips:

  • Keeping a regular sleep schedule by getting up and going to bed at the same time every day
  • Getting an adequate amount of natural light by going for a walk
  • Getting enough exercise, while not exercising a few hours before bed
  • Avoiding artificial light a few hours before bed and using a blue light filter on computers and smartphones
  • Not eating or drinking a few hours before bed
  • Maintaining a cool, dark, and quiet sleep environment

In addition to establishing healthy sleep habits, you can also work towards getting a good night’s sleep by getting tested and treated for sleep conditions like sleep apnea and insomnia. Again, the former is a condition where the sleeper stops and starts breathing throughout the night, while the latter is a condition where the sleeper can’t fall or stay asleep. Johns Hopkins recommends CPAP machines as a common treatment for sleep apnea, and cognitive behavioral therapy with a doctor as a common treatment for insomnia.

Finally, you can improve your sleep quality by addressing other health conditions getting in the way of your sleep. High stress levels are one, and you can help manage your stress levels in a variety of ways, including eating well, avoiding alcohol and drugs, regularly exercising, meditating daily, keeping good time management habits, and making changes to how you approach stressful situations mentally. As we mentioned above, heart disease is another. If left untreated, it can actually lead to poor sleep quality and cause a vicious cycle. This is why it’s important to take the proper medications if you already have a diagnosis for heart disease.

Learn More About Heart Disease and Sleep

Below, you’ll find a list of resources for people who want to improve their sleep habits while living with heart disease. Living with heart disease can be very difficult. As some of the resources below may have advice for lifestyle changes, you should always consult a doctor before you try out a new treatment or for additional help.

Information:

The Center for Disease Control and Prevention’s Pamphlet on Heart Disease: Published by the CDC, this brochure collects all of the basic facts about heart disease for a quick and easy reference you can print out.

WebMD’s Reference Page on the Link Between Heart Failure and Sleep: Like the other articles linked here, WebMD’s reference page breaks down in detail the link between heart failure and sleep issues. It also addresses common heart failure myths, and gives tips on how to sleep well when you have conditions that may lead to heart issues.

Articles: 

Harvard Medical School’s Health Letter on Sleep and Heart Health: Published on Harvard Medical School’s website, this article breaks down the links between sleep and heart health, gives advice for improving your sleep health, and includes a quick quiz for you to see whether you should consult your doctor about possibly having sleep apnea.

The American Heart Association’s Article on Sleep, Women and Heart Disease: Aimed at women, this article breaks down the link between sleep and heart disease specifically for women, and includes info on women-specific health conditions that impact sleep like menopause.

The American College of Cardiology’s Article on Insomnia and Heart Disease: Published by the American College of Cardiology, this article goes in depth on the research linking insomnia and heart disease, and also links to additional workbooks, online resources, and sleep specialists who can help with treating insomnia.

The AARP’s Article on Too Much Sleep and Heart Disease: Most of the other articles and resources on this page talk about the link between sleep deprivation and heart disease. This article published by the AARP, on the other hand, explains in non-academic language a recent study that shows the links between heart disease and having too much sleep.

Support Groups: 

Mended Hearts: A nationwide organization, Mended Hearts has the world’s largest peer-to-peer heart patient support network. Volunteers give support not just to patients, but family members and caregivers, too, and there are options for in-person, online, and phone visits.

Mended Little Hearts: Run by the same organization that oversees Mended Hearts’ peer-to-peer support network, Mended Little Hearts does the same for child patients with congenital heart disease, as well as their families.

SisterMatch: Run by Women Heart: the National Coalition for Women with Heart Disease, this resource connects women who have heart disease one-on-one with volunteers who can give in-person, phone, and/or email support.

GoRedforWomen: Run by the American Heart Association, Go Red for Women is an initiative that provides education, resources, and community support specifically for women who have heart disease. In addition to one-on-one support and an online community, over 100 local chapters meet monthly nationwide.

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