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How much sleep to avoid heart disease?

Sleep has been implicated as both a causative factor and a means of reducing heart disease by a recent study. This could have considerable implications in India, where heart disease is the number one cause of death in the nation — by a considerable margin.

“We have to include sleep as one of the weapons we use to fight heart disease — a factor we are compromising every day,” said Jose M Ordovas from the Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC) in Spain.

Ordovas was one of the researchers in the study, published in the Journal of the American College of Cardiology. It found that poor quality rest increases the risk of atherosclerosis — a condition in which plaque, formed of fat, cholesterol and other substances builds up in the arteries throughout the body.

             Heart disease is the leading cause of death in India

Six to eight hours, the sweet spot for sleep


The study’s findings present an issue, too little sleep — notably, below six hours — was found to increase the risk of atherosclerosis. The data indicated that after all other factors were accounted for, the risk of atherosclerosis rose by 27 percent in those consistently attaining less than six hours.

This issue works the other way too. If an individual was found to be sleeping for too long, similar increases in risks were observed. The study specified that among the participants the number who slept more than eight hours was low, but it was found that women who slept more than eight hours showed an observable rise in atherosclerosis risk. While the study specifies women, it may not be the case that the increased risk only applies to women, simply that there may have been limitations in the participant group.

For many in India the news that sleeping for short lengths of time can be hazardous to health is unwelcome news. Particularly in urban environments where shifts may be long and commutes may take hours, sleeping is often a luxury.


Disturbed sleep and the interaction of substances


The quality of sleep was also a factor being assessed. This was explained as the number of times an individual wakes up during a sleeping session, as well as bodily movements during different sleeping phases.

In many cases the number of hours spent asleep may be irrelevant. If the person is consistently waking up throughout the night the effects on the body may be similar to that of a lack of sleep.

In terms of quantitative figures, the study suggests that those who sleep within the six to eight hour region but have a lack of quality sleep increase the risk of atherosclerosis by 34 percent. This figure is important as it indicates that a lack of quality sleep can have more of an impact than not getting enough sleep.

The study found that consumption of alcohol and caffeine were often to blame for the disturbed sleeping cycles in the participant group.

Alcohol in particular is often used by people as an aid to sleeping, when in fact, it can have the opposite effect. “If you drink alcohol, you may wake up after a short period of sleep and have a hard time getting back to sleep. And if you do get back to sleep, it’s often a poor-quality” said Ordovas.


Implications for India


Heart disease is responsible for 28.1 percent of all deaths in India. This figure dwarfs that of any single infectious disease and nearly comes close to the combined figure for all infectious diseases in the country. With such a high burden of heart disease, any new information that can reduce the risks of developing heart disease is welcome.

Atherosclerosis is among the most common causes of heart attacks and strokes, some of the most common causes of death in India. For something as simple as steps to improve the quality and quantity of sleep to reduce the risk of these conditions could be a life saver.

To combat India’s growing noncommunicable disease (NCD) epidemic it is important to address the lifestyle factors that contribute to them. Alongside the risk related to sleeping, physical inactivity and diet play a massive role.

As India drifts away from diets rich in fresh fruit and vegetables in favour of processed fast food, risks of heart conditions rise considerably. Likewise, as labour forces are increasingly moved to sedentary, office based jobs, heart health declines due to the lack of physical activity. Increased awareness may be key to addressing some of these issues, as many are unaware of the degree to which lifestyle choices can play a role in health.


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