Don’t let sleep problems go undiagnosed

Published 11:02 am Wednesday, March 28, 2012

by Dr. Madhukar Kaloji

The link between sufficient sleep and good health is well established.

A growing body of research gives added weight to the argument that shorting yourself on sleep may shorten your life by significantly raising your risk of heart problems.

More than 40 million people in America suffer from chronic sleep problems. Insomnia, the most common sleep problem, affects 30 percent of adults — around 60 million individuals — in America. Another 18 million Americans have obstructive sleep apnea and, of these, 80 to 90 percent are undiagnosed.

Insomnia involves the inability to fall asleep and remain asleep, all night. Sleep apnea is the interruption of sleep due to reduced air intake when the muscles of the throat weaken and the upper airway fails to stay open during breathing.

Sleep disorders can have serious effects on heart health, by raising the risk of heart disease, heart attack, heart failure and stroke. Individuals with sleep difficulties may have as much as a 45 percent higher risk of a heart attack, according to the American Heart Association.

While studies have demonstrated the detrimental effects of insufficient sleep on the heart, the relationship between the two is not clearly defined. Studies show that insufficient sleep does not directly cause heart disease, but increases the risk factors for heart disease — weight gain, stress hormone production and high blood pressure, to name a few.

Shortened sleep duration — less than six hours — can have a variety of negative effects on heart health. Researchers theorize that because blood pressure and heart rate fall at night, sleeping for shorter durations does not allow sufficient time for this restorative cycle of lowered heart rate and blood pressure to take place.

Therefore, the heart has to work harder, and blood pressure remains elevated, which can damage the heart, long-term.

Adults who sleep fewer than six hours per night also produce more of a protein that is usually released during stress or when inflammation is present in the body. High levels of stress hormone and inflammation are also risk factors for heart disease.

Insufficient sleep also can lead to calcium deposits in the arteries, narrowing the pathway for blood flow and raising heart attack risk, according to a 2008 study at the University of Chicago.

This landmark study of 495 men and women ages 35 to 47 documented the exact risk of shortened sleep: one hour less on average each night can increase coronary calcium by 16 percent. Among this group, 27 percent of patients who got less than five hours of sleep each night developed plaque in their heart vessels, compared to just 11 percent among those sleeping five to seven hours and only 6 percent of people who slept more than seven hours nightly.

A 2011 European Heart Journal review of 15 medical studies involving almost 475,000 people found that short sleepers had a 48 percent increased risk of developing or dying from heart disease in a seven- to 25-year followup period (depending on the study) and a 15 percent greater risk of developing or dying from a stroke during this same time.

If you suffer from excessive sleepiness during the day, or have other symptoms of sleep deprivation or a sleep disorder, talk with your doctor about undergoing an assessment to determine your sleeping habits.

Sleep disorders can be diagnosed through some simple tests, including a sleep study, in which the patient is observed during sleep to detect patterns of interrupted sleep, abnormal heart rate and rhythm, and much more. Treatments may include a continuous positive airway pressure device, weight loss, surgery on the windpipe, sleep aids to promote optimal body positioning while sleeping, and dental devices to promote good airflow.

To learn more, visit www.smhfranklin.com by clicking on “Health Resources” and “Interactive Tools,” and take the “Sleep Quiz” or the “Sleep Apnea Quiz.” Or, call 562-6181 for an appointment.

DR. MADHUKAR KALOJI received his internal medicine medical degree from Osmania Medical College in Hyderabad, India. His office, Southampton Surgical and Pulmonary Medicine, is located on the Southampton Memorial Hospital campus, and he can be reached at 562-6181.