Nearly 40 million Americans have long-term sleep problems, with another 20 million to 30 million experiencing occasional sleep problems, according to the National Commission on Sleep Disorders Research at the National Institutes of Health.
And, according to a recent study, stress is a common reason for sleeplessness, and this, it turns out, may be related to heart disease.
The Sleep/Stress/Heart Connection
It’s been shown that high stress can increase your risk for heart disease. We even know why stress increases your risk. It has to do with the fact that increased levels of cortisol, aldosterone and catecholamine have a detrimental effect on your cardiovascular system. However, what is a bit murkier is what specifically causes the level of stress that is needed to set off these hormone increases.
According to one study, stress at work triggered poor lifestyle choices (smoking and high dietary fat intake), both of which are risk factors for heart disease. Another study looked at psychological stress and behavioral factors (smoking, drinking alcohol and exercise), and how they related to actual cardiovascular events. They found that risk for heart disease was directly correlated to psychological stress, and that the stress was highly correlated with poor behavioral choices.
So where does sleep fit in? One study has shown that improving sleep quality can lower a person’s perceived stress levels, but does that necessarily mean that poor sleep correlates to high stress? That’s exactly what researchers of the current study set out to discover.
Researchers used a retrospective analysis of data collected on patients participating in the cardiovascular disease prevention program at the Walter Reed Army Medical Center Integrative Cardiac Health Project. All patients were either referred by a physician or self-referred to the program in an effort to help improve diet, exercise, stress and/or sleep behavior.
Upon entry to the program, participants filled out a variety of questionnaires to assess, among other things:
- Stress levels
- Sleep behavior
- Sleep quality
- Daytime issues related to lack of sleep
They were also tested for cardiovascular risk factors, including:
- Waist circumference
- Total cholesterol
- LDL cholesterol
- HDL cholesterol
- Glucose levels
- Insulin levels
- Hemoglobin A1C
- C-reactive protein
Researchers found that those participants with high stress also had a higher BMI and larger waist circumference. They also had higher C-reactive protein levels. And on the sleep front, those with high stress reported shorter sleep times (about 20 minutes less than those in the low-stress group), poorer sleep quality, increased likelihood of sleep apnea, daytime sleepiness and fatigue.
Interestingly, there was no significant correlation between high stress and cholesterol levels. Similarly, there was no significant correlation between high stress and glucose levels.
Researchers stated, “The finding that glucose and lipids did not correlate with stress in our study places greater weight on the role of sleep disruption in the development of CVD [cardiovascular disease]. In combination with numerous prior studies that connect short sleep and disturbed sleep with CVD, our correlations provide a mechanistic link to support the observed association between stress and CVD.”
A Few Questions for the Questionnaire
While their findings are interesting, the researchers themselves point out a few potential issues. On the surface, one concern could be that the high-stress group only got 20 minutes less sleep per 24-hour period than the low stress group. That doesn’t seem like that big of a deal.
But researchers point out that over the course of a few days or weeks, this deficit accumulates and has a profound impact on mood and performance. Additionally, both quantity and quality of sleep (more specifically, lack thereof) can impact inflammation markers. And high inflammation is associated with cardiovascular disease.
What they did point out as possibly problematic is the chicken or egg scenario. Does high stress lead to poor sleep habits or do poor sleep habits cause or exacerbate stress?
Researchers suggested, “A justifiable next study could examine the impact of stress management strategies and sleep improvement on incident CVD.”
Get To Sleep
There are several natural remedies for treating insomnia. Some of the more common ones include herbs such as chamomile and passionflower. For more than 50 years, chamomile has been shown to help calm nerves and promote sleep. It depresses the central nervous system, reducing anxiety without disrupting normal functioning.
Passionflower works by maintaining your blood levels of serotonin, which promotes sleep. To make a delicious, calming sleep tea, steep two or three heaping teaspoons of chamomile flowers and one teaspoon of dried passionflower leaves in one and a half cups of boiling water and drink 30 minutes before bed.
You can also try 5-HTP. This precursor to serotonin has a calming influence on mood and aggressiveness. Try 50-100 mg to help you sleep.
 Kashani, M et al. Perceived stress correlates with disturbed sleep: A link connecting stress and cardiovascular disease. Stress. 2011 Jun 19. [Epub ahead of print].
 Kubzansky, LD and Adler, GK. Aldersterone: A forgotten mediator of the relationship between psychological stress and heart disease. Neurosci Biobehav Rev. 2010;34:80-6.
 Hellerstedt WL and Jeffery, RW. The association of job strain and health behaviours in men and women. Int J Epidemiol. 1997;26:575-83.
 Hamer, M et al. Psychological distress as a risk factor for cardiovascular events: Pathophysiological and behavioral mechanisms. J Am Coll Cardiol. 2008;52:2156-62.
 Eliasson, A et al. Reducing perceived stress improves sleep quality: A longitudinal outcomes study. Chest. 2010;137:913A.
 Kashani, M et al.