Most of us have experienced the negative effects of a poor night’s sleep before, such as fatigue, loss of concentration, headache, and irritability. But are you also aware of the harmful impact of long term poor sleep on your heart health? According to the American Heart Association, a poor sleep habit is linked to a host of cardiovascular risks such as obesity, high blood pressure, diabetes, and coronary artery disease. Inadequate sleep, usually less than 6 hours per night is especially hazardous. Sleep deprivation leads to higher levels of stress hormones in the blood and possibly promotes inflammation. The effects of losing sleep are cumulative over time, so repeated lack of sleep can really start to add up.
Over the years more and more people are suffering from long term sleep deprivation. In some people it may be voluntary, as they prioritize other pursuits, others may suffer from insomnia or other sleep disorders that curtail a restful slumber. One common but under-recognized cause of poor sleep is obstructive sleep apnea, which is a serious sleep-related breathing disorder that is often but not always linked with loud snoring. Obstruction of the upper air passages can reduce the oxygenation of the lungs, disrupting sleep, and even leading to very low levels of oxygen in the blood. A study by a public healthcare institution found that 1 in 10 Singaporeans have severe sleep apnea, in which they stop breathing for more than 30 times an hour during sleep, and as many as 1 in 3 has moderate to severe sleep apnea. Some of the health disorders that sleep apnea patients are more likely to have include drug-resistant high blood pressure, obesity, congestive heart failure, diabetes, stroke, heart attack, and abnormal heart rhythms. Another study published in a highly regarded journal reported that the risk of a heart attack or stroke was three times higher in men with severe apnea.
Now that we know how important our shut-eye is to our heart, how do we know if our sleep is inadequate? Some clues include falling asleep immediately when laying down to bed, lack of concentration or sleepiness during the day, difficulty getting up in the morning. You can also use the following STOP-BANG questionnaire to predict your likelihood of having sleep apnea. A "yes" answer to three or more of these questions suggests possible sleep apnea, and you should ask your doctor if you should have a sleep study to confirm the presence and severity.
S Snore: Have you been told that you snore?
T Tired: Do you often feel tired during the day?
O Obstruction: Do you know if you briefly stop breathing while asleep, or has anyone witnessed you do this?
P Pressure: Do you have high blood pressure or take medication for high blood pressure?
B Body mass index (BMI): Is your BMI 30 or above?
An Age: Are you 50 or older?
N Neck: Is your neck circumference more than 16 inches (women) or 17 inches (men)?
G Gender: Are you male?
So, what can we do if we are having poor sleep? First check if we have created unhealthy bedtime routines, such as staying up late, having irregular sleeping hours, or doing stimulating activities before bed. Try basic sleep hygiene strategies first, such as going to bed and waking up at the same time each day, keeping your bedroom cool, dark, and comfortable, avoiding alcohol, caffeine, or big meals close to bedtime.
If sleeplessness stems from psychological or emotional issues, such as stressful events, mild depression, or an anxiety disorder, talk to your health care provider about options such as cognitive behavioral therapy, which is a safe and effective approach to chronic insomnia.
For obstructive sleep apnea, the treatment is weight management and continuous positive airway pressure (CPAP) therapy. This involves wearing a face mask connected to a small machine via a lightweight tube. The machine delivers a stream of pressurized air into your nose or mouth that prevents your airway from collapsing. If getting enough sleep is difficult for you, do consider having your heart health checked out as well by a heart specialist, particularly if you experience chest discomfort, breathlessness, or palpitations. Now is the time to stop taking our sleep for granted, and start giving our bodies the time and rest it requires to heal and recover from the physical and mental demands of the day.
Dr. Ting is a senior consultant cardiologist with a special interest in non-invasive imaging and management of heart valve disorders and coronary artery disease. He also plans structured lifestyle therapy programs for patients to reverse or slow the progression of coronary artery disease, as well as treat other lifestyle-related conditions such as hypertension, high cholesterol, diabetes, and obesity.
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