Insomnia can triple risk of heart failure, use these tips to prevent

Mar 11 2013 - 1:00am
Insomnia can triple risk of heart failure
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A large new study suggests that insomnia may increase your risk of developing heart failure by a whopping three times, according to a report in the March 6 edition of the European Heart Journal.

Although it’s been established that heart problems can definitely lead to sleep problems, lead researcher Dr. Lars Laugsand says he and his colleagues launched the study to try and determine if the reverse might also be true. In other words, could insomnia lead to heart failure risk?

"Insomnia is a frequent and easily recognized, potentially manageable and treatable condition," said Laugsand, from the Norwegian University of Science and Technology. He added that his team found an association between insomnia and heart failure, but they did not find that insomnia definitively causes heart failure.

"We still do not know whether heart failure is really caused by insomnia, and it is still unclear why insomnia is linked to higher heart failure risk," Laugsand said.

According to the National Institutes of Health (NIH), heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. In some cases, the heart can't fill with enough blood. In other cases, the heart can't pump blood to the rest of the body with enough force. Some people have both problems.

The term "heart failure" doesn't mean that your heart has stopped or is about to stop working. However, heart failure is a serious condition that requires medical care.
As for the link between insomnia and heart failure, Laugsand said his team’s research suggests a biological cause may explain the connection.

"One possible mechanism could be that insomnia activates stress responses in the body that might negatively affect heart function," Laugsand explained. "If our results are confirmed by others and there is a real causal association, evaluation of insomnia symptoms might have consequences for cardiovascular prevention."

For the study, researchers collected data from over 54,000 male and female participants from a prior study on public health factors, which was conducted between 1995 and 1997. At the time, none of the participants had heart failure. They then asked the participants about the quality of their sleep, and if they had difficulty going to sleep and staying asleep.

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Researchers followed up with the participants 11 years later, and found that over 1,400 participants had since developed heart failure – and those experiencing multiple symptoms of insomnia had a threefold increased risk of developing heart failure, compared to people who reported no problems sleeping. If they were experiencing depression and anxiety too, the risk for heart failure nearly quadrupled.

The participants who reported symptoms of insomnia 11 years later, said they felt tired in the morning at least once a week due to problems going to and staying asleep nearly every night of the week. The fatigue they experienced due to lack of sleep was associated with an increased risk of heart failure, compared to those who reported sleeping well or rarely suffering from any insomnia-like symptoms.

Two earlier studies also indicate that insomnia is may also be associated with the risk of heart failure, and according to Dr. Gregg Fonarow, professor of cardiology at the University of California and a spokesman for the American Heart Association, insomnia can increase the body's inflammatory and stress responses.

"Activation of these systems, as well as other mechanisms, may link insomnia to an increased risk of developing heart failure and other cardiovascular disease," Fonarow said. "However, whether preventing or treating insomnia would lower the risk of developing heart failure requires further study."

If you’re struggling with insomnia, it’s important to see your doctor to rule out any underlying cause associated with a disease or illness. In the meantime, relaxation techniques can help. Yoga, meditation and guided imagery are often recommended to help prepare the body for sleep, as well as exercise if done early in the day.

Here are some additional tips from the National Sleep Foundation that may help prevent insomnia:

At night:
• Use the bed and bedroom for sleep and sex only
• Establish a regular bedtime routine and a regular sleep-wake schedule
• Do not eat or drink too much close to bedtime
• Create a sleep-promoting environment that is dark, cool and comfortable
• Avoid disturbing noises – consider a bedside fan or white-noise machine to block out disturbing sounds

During the day:
• Consume less or no caffeine, particularly late in the day
• Avoid alcohol and nicotine, especially close to bedtime
• Exercise, but not within three hours before bedtime
• Avoid naps, particularly in the late afternoon or evening
• Keep a sleep diary to identify your sleep habits and patterns that you can share with your doctor

Reference: Laugsand LE, Strand LB, Platou, et al. Insomnia and the risk of incident heart failure: A population study. Eur Heart J 2013; DOI: 10.1093/eurheartj/eht019. Available at: http://eurheartj.oxfordjournals.org

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