Cardiovascular 💓 Health and Lifestyle Medicine🌿Part 5 - Sleep💤

 

Today we reflect on the role of sleep 😴 in our long-term health for Cardiovascular disease CVD prevention.  Sleep requirement is built into the survival of all species🐬🌵🚶🏽. It is extraordinarily important for good memory and can increase our IQ. Students who get sufficient sleep display better exam results 🏆 and higher IQ.   Lack of sleep for many people is just a part of “modern life”. Behaviorally induced insufficient sleep disorder (BIISD) is one of the most common conditions relating to sleep. This is a condition that leads to not meeting the recommended requirements for sleep. So why are we giving up our precious sleep time?

 

We shouldn’t be⛔️. Our internal body clock 🕰 controls our circadian rhythm, which allows us to transition between sleep and wakefulness. In the cycle of sleep, we experience different ratios of deep sleep and rapid eye movement (REM) sleep.

 

The following examples of CVD risk relate to sleep disorders include:

 

·       Higher levels of systemic inflammation

·       Impaired DNA repair, crucial for good Cardiovascular (CV) health

·       There is a higher risk of heart attacks and death from CV related incidents.

·       Hypertension risk at night is raised.

·       Abnormal Lipid levels in the blood (dyslipidemias) can take place.

·       Perfusion of blood in our limbs has a higher risk of being reduced.

·       Risk of injury to the blood vessel linings (endothelial cells) throughout the body and heart

·       Vasospastic disorders (An example is Raynaud’ s phenomenon, a disorder of the blood vessels in the hands and feet)

 

Examples of sleep disorders include but not limited to BIISS, insomnia, restless leg syndrome, sleep apnoea, obstructive sleep apnoea and insomnia related to depression. These are all associated with CVD.

 

So, what are some of the Lifestyle factors 🌿that can help reduce CVD risk/progress for more healthy sleep?

 

•   Good quality sleep hygiene

 

Try and cut out using any blue light 💻2 hours before sleeping, especially too much television 📺 or use of iPads 📲 and smart phones 🤳🏽. Dim the lights one to two hours before sleep. A warm non caffeinated beverage 🍵 is helpful, and so is a nice warm or cool face wash. Keep nice and warm in bed, especially feet. The room temperature should be approximately 18 degrees Celsius, or a little bit higher for some. Reading in bed is not recommended⛔️, better at least 1 hour prior to sleeping. A warm bath 🛀 before sleep can be helpful. I recommend 5 minutes of mindfulness-based meditation practice 🧘‍♀️ 🧘 🧘‍♂️. “Smiling Mind” is a wonderful program for that, and it is also a non-profit organization of extraordinary quality. It’s guided, has courses to teach you, you can find it under notes down below the index. Stress relief☯🙏 is very important for better sleep, and so is social integration. We will discuss those topics next week. Keep power naps 😴 during the day no more than 30 minutes, and make sure your bedroom is quiet. Stay away from high salt foods and cut out snacking before sleep. Alcohol should not be consumed 3 hours before you are ready to sleep.

 

•   Good Nutrition

 

The best nutrition for prevention of sleep disorders is a whole food plant-based 🍓 🌽🍆 diet, rich in fruit, vegetables, legumes, beans, nuts, seeds, herbs and whole grains. Diets of particular benefits for improving sleep quality and duration include the Mediterranean diet and the DASH diet, where research has demonstrated their significant benefits on sleep quality. Food to avoid include processed food, excessive red meat intake, take away food, and food high in salt, refined sugar and saturated/trans fats. A recent study reported in the Nature journal found that an improvement of sleep quality was achieved with a vegetarian diet 🥗 🍇 🫘 🫑 🌽 🥕 over an Ominvore (plant and animal) diet 🍗 🧀 🥩, due to the positive effect on mental health, demonstrated by a reduction in depression symptoms (with lower Pittsburgh sleep quality index (PSQI) scores).

 

 

 

•   Improving activity levels

 

There have been high quality studies showing that both the quality of sleep and its duration are both improved with activity 🏄🏽🏊🏽⛹🏽🚴🏽🤸🏽  . Moderate regular exercise🚶🏽 has been shown to be sufficient, but best not to be done to close to bedtime. Insomnia and sleep disturbance risk are often associated with inactivity and sedentary lifestyles.

 

•   Weight loss

 

In 2016 there were 1.6 billion people who were overweight, and 650 million people who were obese globally.  In U.S.A.  there are over 70% of the population who are overweight or obese, and at risk of further CVD. Losing weight for a person with obesity can reduce the risk of developing Obstructive Sleep Apnoea (OSA) by 50% and applies to many other sleep disorders. There is a very significant relationship between our weight and risk of developing CVD. And this directly relates to our sleep quality and sleep duration.  For this reason, weight loss or control is a very important part of Lifestyle Medicine prevention of CVD.

 

 

Age 🧧can affect on our sleep quality, often showing shorter sleep duration and quality of sleep as we grow older. Genders can also influence sleep quality, as some women are at higher risk of insomnia than men. But don’t let either of these variables stop you from working on better sleep quality and duration.

 

In summary, I hope this very brief introduction to the subject of sleep 🛌🏼in the CVD risk context has been helpful. There are much deeper levels we can dive into regarding the practice and principles of sleep medicine and CV health. But this will help you understand the necessity of seeking further medical assessment of your sleep quality and duration. See you next week for a discussion on stress 😔, social integration 🧑‍💻and CVD risk.

 

 

 

 

 

References

 

Kelly, J et al, Foundations of Lifestyle Medicine Board review manual. American College of Lifestyle Medicine. 2021.  267-288.

Cholley-Roulleau, M et al, Restless leg Syndrome and cardiovascular disease. A case control study. APR.  PLoS One 2017.

Cholley-Roulleau M, Chenini S, Béziat S, Guiraud L, Jaussent I, Dauvilliers Y. Restless legs syndrome and cardiovascular diseases: A case-control study. PLoS One. 2017 Apr 26;12(4):e0176552. doi: 10.1371/journal.pone.0176552. PMID: 28445539; PMCID: PMC5406016.

Pache, M eat al, Cold feet and prolonged sleep-onset latency in vasospastic syndrome. The Lancet, Vol 358. July 14, 2001.

 

Walker, Matthew. Why we sleep. P.1-368. Penguin Books. 2018.

Wang, X., Song, F., Wang, B. et al. Vegetarians have an indirect positive effect on sleep quality through depression condition. Sci Rep 13, 7210 (2023) https://doi.org/10.1038/s41598-023-33912-7.

 

Notes

Smiling mind can be found at  www.smilingmind.com.au

This can be downloaded onto your Android or Apple Smart phone, and has a set of sleep meditations, so earbuds in bed can help.