Is Insomnia Bad for Your Heart?

Q: I’ve never been a good sleeper. Is insomnia bad for the heart? Should I be worried?

A: Studies support the notion that less than seven hours or more than nine hours of sleep are associated with coronary artery disease (CAD). Poor sleep is linked to weight gain, diabetes, high blood pressure and increased sympathetic nervous system activity — all factors that may explain this relationship.

In one major sleep study, men who slept fewer than six or more than nine hours had a 1.7-fold higher death rate than those who slept seven to eight hours. Another study of more than 71,000 women found those who slept less than five or more than nine hours had a 1.82- and 1.57-fold higher risk of developing CAD, respectively.

Sleep apnea has been linked to several heart conditions, including atrial fibrillation, sudden cardiac death, high blood pressure and heart failure. However, a 2017 study showed that even when accounting for risk factors that included sleep apnea, sleep disturbances such as poor-quality sleep, short-duration sleep, difficulty staying asleep and use of sleeping pills were associated with an up to 70% higher likelihood of CHD and 45% increased risk of stroke.

It appears that getting seven to eight hours of sleep a night is best. However, the National Sleep Foundation reports that only one-third of U.S. adults get eight hours of sleep a night, and up to one-third get six hours or less.

You can improve your sleep habits by getting regular exercise, avoiding daytime naps, avoiding caffeine and powering down electronics before bed. Maintain a strict sleep schedule, which means going to bed and getting up at the same time every day. If you’re overweight, snore or have been told you stop breathing during sleep, see a sleep specialist and be evaluated for sleep apnea.

Otherwise, if you have insomnia or other type of sleep problem, avoid rushing to use over-the-counter sleep aids. Work with your health provider to determine the cause and discuss remedies.

— Interventional cardiologist Leslie Cho, MD