Insomnia endangers the heart after a heart attack (and beyond)

Lack of good quality and quantity sleep increases the risk of new serious events, such as heart attack, stroke, or death by 16%.

Those who have heart disease or have suffered a heart attack need to get plenty of rest. Sleep is also necessary for persons who have stents or have undergone bypass surgery.

For these individuals, a lack of restorative sleep in terms of both quality and quantity increases the risk of new cardiac events requiring hospitalization, such as heart attack, stroke, or the onset of decompensation, as well as mortality from circulatory difficulties.

When compared to individuals who have no issue slipping into Morpheus' arms and staying there for a long period, the risk associated with this factor would increase the danger by roughly 16 percent.

Half of those with heart problems don't get enough sleep.

A study published in Sleep Advances and presented at the European Society of Cardiology (ESC) Preventive Cardiology 2022 congress emphasizes the need of adequate rest for patients suffering from cardiac disease (and not only). The topic is timely, given that statistics reveal that over half of persons with cardiovascular disorders have trouble sleeping effectively, even when accounting for psychological factors that affect sleep and are especially tough for heart patients. "Even after accounting for anxiety and depression symptoms, our study found that insomnia was remained significantly related with cardiac events," says lead scientist Lars Frojd of the University of Oslo. According to the findings, heart patients should be assessed for sleeplessness and given suitable treatment.

The study looked at about 1050 patients (almost one in every five women) who were checked on average almost a year and a half after having a heart attack and/or having a treatment to open clogged arteries (stent implantation or bypass surgery. ). The Bergen Insomnia Scale questionnaire, which is based on diagnostic criteria for insomnia, was completed by the participants. Six questions include the ability to fall and stay asleep, waking up prematurely, feeling insufficiently rested, daytime exhaustion interfering with job or social activities, and sleep dissatisfaction. In addition to the evaluation of C-reactive protein as an indicator of inflammation, the survey looked at smoking habits and LDL cholesterol levels, as well as maximal pressure and waist circumference. The presence of diabetes and the amount of physical exercise were also assessed.

Four years of self-observation

Acute cardiovascular events, such as mortality or hospitalization for myocardial infarction, revascularization, stroke, or heart failure, were tracked. At the time of the study, 45 percent of the participants had insomnia, and slightly under one-quarter had used sleeping drugs in the previous week. In the study population, 364 incidents were observed over a period of more than four years. Patients with insomnia had a relative risk of recurrent incidents of 1.62 after adjusting for age and sex, 1.49 after adjusting for coronary risk factors, and 1.48 after adjusting for comorbid diseases. Even when anxiety and depression symptoms were taken into account, the risk remained high. If none of the patients had sleeplessness, 16 percent of repeated major adverse cardiovascular events may have been averted.

Patients should be given practical counsel.

"While the link between sleep disorders and adverse cardiovascular events appears to be clear, we doctors must focus on practical advice to give to our patients, because cardiac events often result in psychological trauma that people need time to process, says Carlo Tumscitz of the University of Ferrara's Cardiology Center. Anxiety disorders and insomnia are sometimes exacerbated by this. Furthermore, an increase in health worry, particularly when one is on the verge of losing one's life due to an acute occurrence, can make patients more likely to quit harmful habits."

Diet, relaxation, and exercise

So, what are your options? Changing a demanding work habit with little attention to rest, incorporating even modest or moderate physical exercise into one's daily routine, and changing one's nutrition by avoiding large meals in the evening have the dual benefit of boosting metabolic function and allowing for better sleep. "The expert finds that good habits and proper rest have a significant impact on cardiovascular health. When insomnia becomes unbearable, don't be afraid to seek help from an expert who can also properly provide extra pharmacological therapy. However, finding a balance on all fronts that allows for truly durable and effective long-term benefits is not enough ",



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