A proper good quality sleep is one of the primary determinants of optimal cardiovascular health . Why is sleep so important? And what do you mean by a proper and a good quality sleep? In medical terms, a proper good quality sleep is one which is composed of four to five cycles of light, deep and rapid eye movement sleep. Now, but this is a technical term.



In layman's term, a good quality sleep is uninterrupted sleep for at least six to eight hours.



Why is sleep so important?Now, the importance of sleep is basically derived from studies in which people who are sleep deprived by pathological disorders like obstructive sleep apnea and their correlation with cardiovascular health. Subsequently, in normal population or in people who are sleep deprived because of emotional factors, social factors, and because of personal factors, such as the constant availability of entertainment and information at the click of finger, which leads to long night hours and constant working on the desktop or the tablet or the mobile can lead to sleep deprivation and poor quality sleep.



What happens during normal good quality sleep?

During normal good quality sleep, there are various changes which happen in the internal systems of the heart like the cardiovascular system, the hormonal system and the internal metabolic milieu. In the cardiovascular system, there is a 10% drop in your blood pressure and heart rate. This is called as a nocturnal drip.



In patients who are deprived of sleep, this nocturnal drip does not happen. And one of the earliest sign of patient developing hypertension is the absence of this nocturnal drip. Second is your hormonal regulation.



Normally, we have a significant amount of cortisol release, which happens during the early morning hours, which tends to wane off. But people who are sleep deprived, there is a 30% less amount of cortisol secretion during early morning hours and increased cortisol secretion in the afternoon hours. Third thing, the third thing, the repair and the regeneration process tends to be significantly blunted in patients who are chronically sleep deprived.



These leads to increased chances of cell injury and increased occurrence of chronic inflammation. Now we all know this chronic inflammation has been associated with increased risk of cardiovascular disease, obesity, insulin resistance and heart failures. Hence, an optimal and a good quality sleep is necessary and vital for the maintenance of cardiovascular health.



If in chronic sleep deprivation tends to increase the risk of hypertension, arrhythmias, metabolic dysregulation, obesity, coronary artery disease, congestive heart failure. In patients who already have hypertension, who already have blood pressure, chronic sleep deprivation tends to worsen their already pre-existing diseases. So if you have a patient who has got hypertension or diabetes, which is not well controlled, who is requiring mental, who is requiring multiple drugs, just inquire about the quality of sleep.



Most often you will notice that the quality of sleep is very very poor. Hence, counselling of such patients about improving their sleep quality tends to improve the cardiovascular health of the patient.




Dr. Irfan Khan, Associate Director - Cardiology, Dr L H Hiranandani Hospital Powai, Mumbai