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Most people recognize the lifestyle problems that can raise blood pressure to unhealthy levels: smoking, being overweight or inactive, too much stress. In recent years, researchers have confirmed yet another controllable risk factor for high blood pressure—a lack of good sleep.
That insight comes with both good news and bad news. The bad news is that about half of American adults don’t consistently get the recommended 7 to 9 hours of shut-eye each night, according to the National Sleep Foundation. Even our children aren’t sleeping enough. This trend in poor sleep habits may partly explain why hypertension has become an increasing health burden in the U.S. over the past two decades. But the good news is this: better sleep—and, in turn, a lower risk of developing hypertension and other cardiovascular problems—is achievable for most people who make it a priority.
What We Know—and Don’t Know—About High Blood Pressure and Sleep Deficiency
Researchers estimate that people who frequently get fewer than 6 hours of sleep per night are up to 32% more likely to develop hypertension than those sleeping 7 to 8 hours. The consequences of too little sleep could be even bleaker for people who already have hypertension. In a recent study in the Journal of the American Heart Association, people with hypertension who slept fewer than 6 hours per night were twice as likely to die from a heart attack or stroke than those getting 7 to 8 hours.
It’s still unclear exactly how sleep protects the heart, or how too little sleep can cause trouble.
One problem may be that shortened sleep seems to disrupt the body’s ability to regulate or rebalance “stress” hormones, which can raise your blood pressure. Lack of sleep is also linked to increased inflammation, which can strain the heart. And it can interrupt the natural nighttime blood pressure dip that correlates with better blood pressure during the day. In addition, insufficient sleep appears to throw off the body’s appetite-control hormones, which can lead to overeating, obesity, and poor blood sugar control and, in turn, hypertension and other heart health risks.
Learning more about what happens in the body during sleep is an active area of research these days. But clearly, sleep has important health-protective benefits.
Sleeping Too Much May Also Be Risky
While sleeping too little is a clear risk factor for hypertension and other heart risks, too much sleep is also worrisome. In a large analysis in the Journal of the American Heart Association, researchers found that people sleeping for 9 hours on average had a 14% higher risk of death, while 10-hour sleep routines carried a 30% higher risk. They also found a similar increasing risk in cardiovascular disease. Whether sleeping too much is a cause or just a warning sign of heart health risk remains to be seen. But the message is clear: to prevent and better manage hypertension, adults are wise to aim for a consistent 7–8 hours of sleep.
While sleeping too little is a clear risk factor for hypertension and other heart risks, too much sleep is also worrisome. @TaylorMHVICard tells you how to get it right. https://bit.ly/2yJLYxA via @MedStarWHC
What Does Good Quality Sleep Look Like?
While we have a good grasp on what constitutes a healthy amount of sleep, there are currently no standards for measuring sleep quality. Does good sleep mean no tossing and turning? That you don’t wake up during the night? That you spend a set amount of time in different stages of sleep? In the near future, I expect we’ll begin to develop evidence-based standards for sleep quality, along with tools like digital wearables, that help us see how our sleep quality measures up. For now, trust your personal sense of sleep quality and well-being.
If you feel your sleep quality is suffering, be sure to tell your healthcare provider. One very common and treatable cause of poor sleep quality that contributes to elevated blood pressure is sleep apnea, an extreme form of sleep disturbance in which you stop breathing, wake often, and get little deep sleep. According to the American Academy of Sleep Medicine, an estimated 1 in 4 people has sleep apnea today. If you feel tired after a full night’s sleep, especially if you snore, sleep apnea is a likely cause. Today, you can be easily tested at home instead of at a hospital, and treatment options have expanded beyond uncomfortable face masks. We also know that treating sleep apnea helps reduce high blood pressure and other cardiovascular risks.
Your healthcare provider can also identify other common causes of sleep disturbance you may not be aware of. These can include underlying health conditions, such as thyroid or gastrointestinal disorders, or particular medications you may take, such as allergy or asthma treatments, certain pain relievers, and some hypertension medicines.
How to Get Better Sleep
The first step to better sleep is to prioritize it! Sleep is largely a controllable behavior, so getting better sleep is doable by committing to some simple changes. Aim for 7 to 8 hours every night. (Children need even more: 8–10 hours for teens and 9–11 hours for school-age kids.) If you have sleep trouble, talk to your physician to help uncover health or medication issues that might be the cause. Then, stick to these proven sleep hygiene practices to get the health-essential sleep you need to prevent high blood pressure or to better control it.
- Stick to a regular sleep schedule. Go to bed at the same time each night and get up at the same time each morning, including weekends. Get at least 30 minutes of natural light daily, especially earlier in the day. Try going for a morning or lunchtime walk.
- Get some physical activity every day. Try not to exercise within a few hours of bedtime.
- Avoid artificial light from televisions, phones, and computers within a few hours of bedtime. Use a blue-light filter on your computer or smartphone, or try blue-light filtering eyeglasses.
- Don’t eat or drink within a few hours of bedtime, especially alcohol and foods high in fat or sugar. Steer clear of caffeine by early afternoon.
- Keep your bedroom cool, dark, and quiet. No pets or devices nearby.
Good sleep is an essential part of maintaining and improving heart health. If you’re not sleeping long or well enough, make sleep improvement a priority. Consider these sleep hygiene tips first and foremost, and mention sleep concerns to your healthcare professionals. They should be taken seriously, as underlying conditions or medications may play a role. In turn, I strongly encourage the medical community to help their patients sleep better in the same way that we help manage other serious heart risk factors, such as high cholesterol, high blood pressure, and smoking. It may take a bit of effort, but the benefits of sufficient sleep on a regular basis are significant.