Heart Disease Linked to Chronic Insomnia

Medical science has established that the risk for heart disease is shaped by dietary choices, smoking, and exercise habits.

Recent research seeks to add sleep to that list of risk factors. More and better sleep appears to be linked to lower risk factors, while less and worse sleep is linked to higher risk factors.

Dr. Kartik Gupta, lead author of that study, said that “sleep is often overlooked as something that may play a role in cardiovascular disease, and it may be among the most cost-effective ways to lower cardiovascular risk.”^1,2

Gupta pointed to data from their research that found that people who slept between 6 and 7 hours a night generally enjoyed lower risk for heart disease.²

What about people who live with insomnia?

This is an interesting finding. Obstructive sleep apnea (OSA) is often the sleep disorder target that receives all the attention. And no doubt, that’s because pauses in breathing during sleep create multiple conditions for developing cardiovascular disease.

However, what often gets overlooked is how much sleeplessness can impact one’s likelihood of developing heart disease. After all, insomnia affects many more people (as many as 30 percent of the US population).³

What does this mean for people who face night after night of insomnia?

How insomnia might contribute to heart disease

People who do not get enough sleep – and that, of course, includes people dealing with regular bouts of insomnia — are more likely to develop atherosclerosis, or “hardening of the arteries.”⁴

Atherosclerosis creates the perfect conditions for serious heart disease, a category that includes:

• Coronary artery disease
• Heart arrhythmias
• Heart valve disease
• Cardiomyopathy

Poor sleep and the domino effect on the heart

Research published in 2019 showed that poor sleep is linked to atherosclerosis through a series of domino effects:⁴

• Poor sleep activates a substance known as C-reactive protein (CRP) in the body.
• CRP triggers inflammation in the body.
• Over time, inflammation causes the buildup of plaques in the arteries.
• These plaques harden and narrow the arteries.
• Narrowed arteries reduce the flow of blood through the body.
• Reduced blood flow means less oxygen — critical to function — is delivered to your heart and other organs, tissues, and cells.
• The heart, in particular, misses this very important oxygen supply, with the end result being heart disease.

The good news is that, while inadequate sleep creates conditions for the development of heart disease, this research also showed that adequate, quality sleep is protective against atherosclerosis.

Research is in agreement

This research also echoed prior investigations that sought to assess associations between sleep quantity and cardiovascular disease. Those findings found short sleep duration (less than 7 hours of sleep per night) associated with greater risks for developing or dying from:⁵

• Coronary heart disease
• Stroke
• Total cardiovascular disease

In fact, the authors of this research emphasized that “people reporting consistently sleeping 5 hours or less per night should be regarded as a higher risk group for cardiovascular morbidity and mortality.”⁵

It’s not all doom and gloom

Contrary to assumptions, most people living with insomnia still get some sleep. They just might get a little less or don’t feel they get enough.

• Often, people with insomnia will struggle to fall asleep and may lose an hour or 2 at the beginning of the night.
• Others may frequently awaken and find it challenging to return to sleep.
• Still others may fall and stay asleep, but awaken a few hours earlier than desired because they simply can’t sleep anymore.

Don’t forget paradoxical insomnia

This describes a kind of insomnia in which the person feels they have not slept a wink, and yet, an objective study shows they have slept at least 6.5 hours. This “sleep state misperception” happens quite often and creates quite a puzzle for patients and sleep specialists alike when facing the challenges of identifying and treating insomnia.^6,7

How much sleep am I really getting?

What is the average amount of sleep a person with insomnia might actually expect to get? Some research suggests that more than 40 percent of people with insomnia sleep at least 6 hours every night, in spite of their challenges.⁶

So take heart: Even if you face insomnia, it’s likely you sleep more than you think.

The best way to know for sure? Work with a sleep specialist who can help you identify just how much sleep you really get through tests and screening tools. This is especially important if you’re experiencing symptoms of or have been diagnosed with cardiovascular disease.