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Insomnia as a Risk Factor for Heart Disease

Since we have all been sleep-deprived and experienced insomnia-like symptoms, we all know we can survive those two or three days, and continue as if nothing happened. We often forget that lack of sleep can leave far more serious consequences than dark undereye circles. Various heart diseases are one of them, and that is when things become tricky.

Insomnia and various sleep disturbances are hard to deal with, and sometimes there is no other choice than to use sleeping pills in order to put your sleep back in order. Sleep pills are usually the last option that doctors recommend because there are behavioral and lifestyle changes that, in most cases, can help patients to start sleeping regularly. People who already suffer from certain medical conditions or are taking other medications should never take sleeping pills on their own, without consulting a doctor.

Heart disease and sleep pills are one of those combinations that can come with a potential risk. Although insomnia is frequent among the healthy population, around 20% of medical patients are also struggling with it.[1] Among medical patients, the group that struggles the most with sleep are cardiac patients; approximately 44% of them are dealing with insomnia.[2] It appears that this relationship goes both ways since insomnia is recognized as one of the risks for coronary and cardiovascular diseases.

Defining Insomnia

Definitions of insomnia sometimes vary due to the different diagnostic systems, which can cause misconception and inconsistency. Lately, scientists tried to simplify the criteria for insomnia. Before there were two types, primary and secondary insomnia, with plenty of subtypes. Now, the secondary insomnia is removed, as well as multiple subtypes of primary one because they were overlapping and were not distinctive enough.

All these insomnia diagnoses are now known as one, chronic insomnia disorder, which will ease the research and diagnosis. It is never easy to set a diagnose or measure insomnia; hence, a variety of tools such as sleep diaries and questionnaires are used because each of them can show us a different perspective and aspects of sleep problems.

Insomnia in Patients With Heart Failure

The symptoms of insomnia are pretty common in patients with heart failure, particularly, and there are many reasons that justify that. This disease is very stressful; hence, many patients develop disease-related anxiety or depression, which then leads to sleepless nights. Also, certain medications that are a part of therapy can be sleep disruptors or Cheyne-Stokes respiration.

The largest study that examined the relationship between incident heart failure and insomnia was the Nord-Trondelag Health Study, in which the health of 54,279 Norwegian men and women was followed for 13 years. At the beginning of the study, the were all free of known heart failure, but during the years, incident heart failure was linked to symptoms of insomnia.[3]

Insomnia in Patients With Cardiovascular Disease

The relationship between lack of sleep and cardiovascular diseases is still not fully understood. However, there are some aspects of this connection that we can explain. Patients with insomnia have increased cortisol production and adrenocorticotropic hormone, which is suggesting that there is a higher activity of the HPA axis.

Chronic dysregulation or activation of the HPA axis is potentially dangerous because it brings a higher risk for cardiovascular disease, but also for diabetes, insulin resistance, depression, and anxiety. It is known that insomnia can also lead to diabetes, so in this case, it can even be a mediator on the pathway to cardiovascular disease.

Insomnia in Patients With Coronary Heart Disease

Patients with coronary heart disease are at high risk of insomnia; approximately one-third of all patients with initial acute coronary syndrome claims to have the symptoms.[4] A large population-based study conducted in Taiwan included 22,040 people who were diagnosed with insomnia and the same number of people who were not insomniacs.

For ten years, researchers followed participants for stroke or acute myocardial infarction. The results were shocking. People with insomnia had a 68% higher risk chances of an accident myocardial infarction and an 85% higher risk of stroke.[5] The data supports the thesis of insomnia as a serious risk factor for coronary heart disease.

How to Treat Insomnia Successfully

Cognitive-behavioral therapy for insomnia (CBTI) is a highly efficient way of surpassing the symptoms of this sleep disorder. These interventions show significant improvements in the sleep of adults and children diagnosed with insomnia. Besides insomnia, these techniques or tips can generally help sleepers to achieve a higher quality of their sleep and wake up feeling well-rested.

  • Sleep hygiene can be seen as a set of rituals and environmental improvements, with one goal, to induce sleep. Taking care of your sleep hygiene means that you will avoid napping and caffeine during the late afternoon. Creating a relaxing pre-bedtime routine and quiet surroundings for sleep is also a part of hygiene.
  • Relaxation techniques are essential because sometimes we are not aware of how hard it is to relax truly, and not just physically, our brain needs to be relaxed as well in order to fall asleep. Yoga and breathing exercises can be particularly helpful for relaxing your mind and inducing sleep.
  • Stimulus control aims to help you establish a better connection between sleep and bed. For example, if you cannot fall asleep after 20 minutes in bed, get up, read something, or walk around the house, and then come back to try again. Also, the bed is for sleeping, so forget about work and answering emails while in bed.
  • Sleeping pills are often mentioned as an effective means for treating insomnia, but it is important to know that people who suffer from heart diseases should not use them on their own. These medications can cause side effects or interfere with your therapy, etc.
  • And, it is important to mention that sleeping pills are not the best way to solve the problem, the only way to achieve long-term success and say goodbye to your insomnia is to follow CBTI and change your lifestyle.

Considering all the serious medical conditions that insomnia can trigger, it is essential to realize how dangerous a chronic lack of sleep can be.

[1] Budhiraja R, Roth T, Hudgel DW, Budhiraja P, Drake CL. Prevalence and polysomnographic correlates of insomnia comorbid with medical disorders. Sleep 2011;34:859-67.

[2] Taylor DJ, Mallory LJ, Lichstein KL, Durrence HH, Riedel BW, Bush AJ. Comorbidity of chronic insomnia with medical problems. Sleep 2007;30:213-8.

[3] Sogol Javaheri, MD, MPHa,and Susan Redline, MD, MPHa,b, Insomnia and Risk of Cardiovascular Disease, Chest. 2017 Aug; 152(2): 435–444.

[4] Coryell V.T., Ziegelstein R.C., Hirt K., Quain A., Marine J.E., Smith M.T. Clinical correlates of insomnia in patients with acute coronary syndrome. Int Heart J. 2013;54(5):258–265.

[5] Hsu C.Y., Chen Y.T., Chen M.H. The association between insomnia and increased future cardiovascular events: a nationwide population-based study. Psychosom Med. 2015;77(7):743–751.

Selena Thomas

Selena Thomas is a content writer who loves sharing tips on healthy lifestyles. A writer by day and a reader by night, she’s fond of writing articles that can help people in improving both physical and mental health. Also, she loves traveling and inspires people on her blogs.