A 40-year-old woman fainted in an outpatient setting in the middle of a busy afternoon. While everyone was anxious, fearing an emergency, I woke up in less than a minute. It was found that she had entered a state of partial sleep, an involuntary bout of sudden, uncontrollable sleep lasting 30 seconds or more, during which her brain stopped working for a period of time. She was chronically sleep deprived. Upon investigation, we found that she suffers from severely high blood pressure of about 175/11 mmHg, and high blood sugar and cholesterol. She was also overweight. All her features revolved around one problem, which was that she could not sleep for more than four hours.
“Doc, I’ve been taking melatonin supplements and I’m still not getting good sleep,” she said to me. Now, melatonin supplements, which mimic the function of the sleep-inducing hormone, are not suitable for everyone. Very few people know that it does not work in cases of lack of sleep caused by stress, hormonal imbalance or underlying conditions. Furthermore, dietary supplements are not a prescription drug and their composition may not be standardized. Therefore, taking melatonin supplements without a doctor’s supervision or recommendation is not a solution. Furthermore, there is a lack of data regarding its long-term safety.
Now, reviewing five years of health records for more than 130,000 adults with insomnia who used melatonin supplements as a sleep aid for at least a year, they found they were more likely to develop heart failure, need to be hospitalized for the condition or die from any cause. This review, published by the American Heart Association, is observational in nature, showing an association but not causation but certainly proving that supplements cannot work magic if there is an underlying condition, cardiac or otherwise, for persistent insomnia. Only proper sleep hygiene can be resolved through other lifestyle-related disciplinary measures.
Why lack of sleep can increase risks to heart health
Now, my patient was mid-career, and anxiety about her career goals meant she worked for a long time, often carrying them home with her. Like many professionals, she thought sleep was the most negotiable part of her daily routine. What they don’t understand is that it’s the one thing that’s non-negotiable in preventative heart health. Sleep allows the heart to rest and recover, lowers blood pressure and maintains hormonal balance, especially in women.
During deep sleep, blood pressure and heart rate decrease, allowing the heart to recover from the stresses of the day. So less sleep means your blood pressure jumps again, leading to ever-higher readings and an increased risk of heart disease and stroke.
Adequate sleep helps regulate hormones that control stress, appetite and blood sugar. Lack of sleep can lead to higher levels of stress hormones such as cortisol, forcing the heart to work harder. Getting enough sleep means that the satiety hormone leptin works long enough with the brain and food is digested properly, which helps with calorie balance, weight management and blood sugar control.
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Lack of sleep is linked to increased inflammation in the body, which leads to hardening of the arteries, damaging the lining of blood vessels and leading to heart rhythm disturbances or arrhythmia. But most importantly of all, sleep builds immune cells, helps them retain disease-fighting memory and strengthens antibodies.
How my patient modified her sleep patterns
Many studies have shown that the heart loves continuous sleep. My patient made simple changes. I stopped drinking coffee or tea at four. No matter where she was, she always made sure to eat her last meal of the day by 7.30pm and planned walks and other activities before planning to sleep between 11 and 11.30pm. In fact, I worked on an on-screen curfew. Whether it’s TV/screen time, she will stay away from them from 10pm onwards. I used in-app notifications to monitor curfews and silence alerts. At the same time, she developed the habit of reading before bed, and over time, she developed the habit of writing about her wayward thoughts herself.
The work she brought home, she could have done better by waking up rested, early, and alert. As her sleep improved, her anxiety, blood pressure and blood sugar decreased, and she lost some weight. These improvements encouraged her to exercise regularly.
Sleep is the most important and most manageable aspect of preventive heart health. And no supplement can reset your body better than changing your habits.
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(Dr. Shetty is Principal Cardiologist and Medical Director, Sparsh Hospital, Bengaluru)
© Indian Express Private Limited
(tags for translation) Partial sleep
