One of the best – and arguably easiest – things you can do for your heart health and overall well-being is sleep. However, a good night’s sleep remains elusive for many. The Centers for Disease Control (CDC) reports that more than 1 in 3 Americans sleep less than the minimum recommended 7 hours per night. The estimated annual economic cost of poor sleep due to productivity loss is $411B in the US. That is despite a global “sleep economy” valued at $585B worth of devices and other sleep aids designed to enable a better night’s sleep. So it was the other night at approximately 3:30 a.m. while I lay awake that it occurred to me that I should write an article on the importance of sleep for heart health. So here we are, and here I am edging close to my bedtime staring at a laptop screen and tapping away at an article about sleep. Irony, stupidity, or both?!
After reading this article you will better understand the impact of sleep on heart health, and how to optimize for good sleep.
What is Considered Good Sleep?
Two key components of good sleep are duration and quality. Sleep duration is fairly self-explanatory and the guidelines call for adults to sleep 7-9 hours, or 7-8 hours for those over the age of 65. Sleep quality is a bit more complex. According to the National Sleep Foundation (NSF), sleep quality is a function of:
- Sleep latency – how long it takes to fall asleep
- Sleep waking – how often you wake up through the night
- Wakefulness – how many minutes you spend awake at night after you first go to sleep
- Sleep efficiency – the amount of time you spend sleeping while in bed; should be >85% for optimal health benefits
Consistent sleep through the night is important as it allows the body to cycle through the various sleep stages: REM (the dream stage) and non-REM (light sleep + deep sleep). According to the Sleep Foundation (not related to the NSF), healthy sleep involves cycling through the sleep stages multiple times during the night. As the night goes on, the non-REM stages become shorter. While all stages serve a purpose, the Deep Sleep stage – also known as Slow Wave Sleep (SWS) – is the most restorative as this is when your body releases growth hormones, builds and repairs bones, muscles, and tissues, and replenishes energy stores among other important functions. Up to 20% of our sleep time is spent in deep sleep and too little deep sleep can be detrimental to your heart health. If you want to dive deep into deep sleep, the Sleep Foundation has you covered.
Why Poor Sleep is Bad For Your Heart
Anyone who has experienced a poor night’s sleep – that’s everyone – knows how hard it can be to complete basic tasks the following day due to lack of energy. Motivating to do daily extracurriculars like a heart-healthy workout can be nearly impossible. On days like that, the only thing that is top-of-mind for most is how to get through the day so they can get to bed and get some rest.
Beyond the physical exhaustion we experience with poor sleep, there’s more happening inside your body when you don’t get enough quantity or quality sleep, and it’s not good and can wreak havoc on your heart:
- Blood Pressure – The experience takes a toll on your body’s internal organs including your heart which uses the reduced heart rate and blood pressure – it usually dips 10-20% at night – that occurs during a good night of sleep to rest and recover. Elevated nighttime blood pressure, according to the National Institutes of Health (NIH) can be an early warning sign for hypertension which is a key risk factor associated with heart disease.
- Inflammation – This is a bit complicated as the relationship is circular. Poor sleep has been shown to cause inflammation. However, inflammation can also cause insomnia. Inflammation, as discussed previously on WellTree may promote the growth of plaques, loosen existing plaque, or trigger blood clots.
- Atherosclerosis – The elevated blood pressure associated with poor sleep can cause inflammation in the walls of your blood vessels. This inflammation leads to the formation of plaque which can lead to heart attack and/or stroke.
- Cortisol – Elevated cortisol levels during the day due to poor sleep can further exacerbate heart strain by increasing blood pressure and blood sugar, contributing to the overall risk of heart disease.
How to Ensure Good Sleep
In this day and age when we are stressed, overworked, and overstimulated by screens and various forms of content, we really have to be intentional about getting good sleep. Sleep hygiene is the term used to describe how you optimize your behaviors and environment to maximize sleep. The following suggestions will help to ensure a restful night’s sleep:
- Plan – If you need a minimum of 7 hours of sleep, work backward to understand what time you need to be in bed based on your wake-up time. My alarm is set at 6 am most days, so I am to be in bed by 9:30 pm and lights out by 10 pm which hopefully allows me to get 7-8 hours of sleep, accounting for awake time.
- Consistency – Maintaining consistent sleep and awake time will help you train your body clock, reinforcing your circadian rhythm. This is particularly important for heart health as a study from the National Sleep Foundation showed that varying sleep timing can have adverse effects on heart health; one finding showed that varying sleep timing by one hour was found to be associated with a 23% increased risk of metabolic syndrome and an 18% increase in cardiovascular risk.
- Ditch Your Phone – According to Reviews.org, more than half of Americans are addicted to their phones and a National Sleep Foundation study found that over half of Americans polled say that they look at screens within an hour before bedtime or in bed before sleep. Blue light produced by screens suppresses the production of melatonin making it harder to go to sleep. If you want good sleep, put down your phone at least an hour before bedtime and read a book.
- Eat Early – Eating large or heavy meals before bed can disrupt your sleep. According to SleepFoundation.org, eating 2-4 hours before bedtime will give food plenty of time to digest helping to ensure quality sleep.
- Limit Alcohol – Alcohol is a sedative and can make it easier for you to fall asleep. But don’t be fooled…as few as 2 drinks for men and 1 drink for women can decrease sleep quality by 9.3%, as reported by the Sleep Foundation. While you may fall asleep more easily, sleep pattern imbalances brought on by alcohol result in reduced sleep duration and an increase in sleep disruptions.
- Limit Caffeine Close to Bedtime – Many of us enjoy coffee, not solely because of the taste, but also because it is a stimulant. Stimulants can be great, but not so great if you want to sleep. A Pubmed study found that caffeine consumption reduced total sleep time by 45 min and sleep efficiency by 7%. While people’s sensitivity to caffeine varies, most reports recommend not drinking coffee within 8-10 hours before you go to sleep. So if your plan is to go to sleep at 10 pm, best to drink your last cup before noon, or 2 pm at the latest.
- Prepare Your Sleep Environment – If you want to optimize your sleep, you will want to optimize your environment. To do so, make sure the room is as dark as possible, set the temperature between 65-71 degrees, and minimize noise.
- Calm Your Mind – Can you relate to lying awake at night worrying while you toss and turn trying to fall asleep? A regular mindfulness practice such as meditation can help you learn to quiet your mind and to focus on presence and gratitude which can help you better manage your worries. Yoga nidra in particular is done lying down and helps to slow brainwaves and prepare yourself for sleep. I highly recommend meditation apps such as Insight Timer where you can find all types of meditation. When it comes to sleep meditation, Jason Stephenson on YouTube and I have an almost nightly relationship where his soothing voice lulls me into a deep sleep.
A common framework that addrssses most of the suggestions above toward optimzing sleep is the 10-3-2-1-0 rule, which is:
- 10 hours before bed: No more caffeine
- 3 hours before bed: No more food or alcohol
- 2 hours before bed: No more work
- 1 hour before bed: No more screen time
- 0: The number of times you hit the snooze button in the morning
Try to follow those guidelines and you’ll be on your way to a good night’s sleep and, more importantly, your sleep will support good heart health. I also highly recommend the use of a sleep tracker – I sleep with my Apple Watch, but there are plenty of options (Oura, Whoop, etc.) – as I find this helps keep me closely engaged in my sleep patterns and allows me to identify trends and make changes as needed. With that said, I’m happily finishing this article hours before my 10 pm bedtime, and I’m looking forward to a good sleep. Good night everyone and stay healthy!