The Recovery Tool I Ignored at First: Sleep

Part of the post heart attack anxiety series

The normal list that most of us heart attack survivors know and, mostly and hopefully, try to do are: diet changes, exercise, cholesterol meds (for some). But almost nobody expects the answer to start with sleep.  Let me, right off the bat, underscore how serious sleep is to get sorted. 

A Mayo Clinic-affiliated study followed about 3,000 adults over 45, and people sleeping fewer than six hours a night were roughly twice as likely to have a stroke or heart attack as those sleeping six to eight hours.

Twice as likely! 

But back before I understood this, sleep was one of the last things I took seriously, and now I know, it really should've been one of the first.

There are a lot of reasons people don’t sleep well. For me, for months after my heart attack, I'd lie awake at 2am and my brain would go looking for trouble. Every weird flutter, every twinge, my mind treating it like a five alarm fire. I assumed it was just normal post heart attack anxiety, a short phase that would be over quickly. And wow was I wrong, on multiple counts. Sleep remains something I work to better and anxiety is too.  And the low sleep hours were actually working against my recovery.

There's a cardiac surgeon at Cleveland Clinic who put it simply: sleeping a solid seven or eight hours a night is a marker of good heart health. It's not a nice-to-have. It is a “marker”, which for me puts it in the same category as blood pressure and cholesterol.

Cleveland Clinic researchers also looked at artery health specifically. Their finding was that every hour of lost sleep was tied to a meaningfully higher risk of calcium buildup in the coronary arteries, which is the kind of buildup that eventually turns into the plaques that cause heart attacks in the first place. So this isn't just "you'll feel groggy." This is your arteries keeping score.

And cortisol, the hormone everyone blames for stress, is also the hormone that runs your sleep-wake cycle. Normally cortisol drops at night and rises in the morning to help you wake up. But Cleveland Clinic notes that chronic sleep issues can throw that rhythm off and keep cortisol running higher than it should both night and day. Add in regular life stress, and well, we’re not looking too great. And elevated cortisol doesn't just sit there. It tells your pancreas to dial insulin down and glucagon up, which pushes your blood sugar higher. Higher drops mean, lower lows (ever realized how much hungrier you are after a bad nights sleep?) So, the bottom line is, bad sleep isn't a side issue sitting next to your blood pressure and blood sugar problems. It's actually feeding them.

And there are other data points. Less sleep doesn't just wear you out, and cause higher blood sugar spikes. It's also linked to higher blood pressure, and more inflammation, and all three of these are already working against you if you're managing heart health. The Mayo Clinic lists it plainly: not getting enough sleep raises your risk for high blood pressure, atrial fibrillation, and even heart failure. That's a heavy challenge to stack on top of an already tired body.

So what can we do?

So if it were me, and it was me, I'd stop treating sleep like a scheduling afterthought. Put in on your calendar like a doctor’s appointment. Seven hours, most nights, roughly the same time. Not five hours and a coffee chaser. Not a weekend catch-up binge to make up for a rough week, because the research says that doesn't really work the way we wish it did.   Scheduling it at the same time every night, will eventually help you sleep better. Less screen time too (read a book to unwind, rather than scroll, since screen time wakes your brain up).  And when you are low on magnesium your sleep is affected too. There are other tips but this post is about how sleep effects heart health. 

I'm not a doctor. I'm not going to pretend I fully understand every mechanism behind why sleep and your heart are this connected. Research and articles from Cleveland Clinic and Mayo Clinic worth reading. But I can tell you that once I got serious about sleep, consistent bedtime, actually protecting those seven hours, the anxiety got quieter.

There's actually another piece to this story too, one about how this same cortisol and blood sugar pattern connects to insulin resistance over time. That's a conversation for next time, because it deserves its own space.

Because you only get one heart.

Till next time, Stephen.

Sources: Cleveland Clinic, “Why You Need to Get Enough Sleep for a Healthy Heart,” “How To Keep Your Heart Healthy and Strong,” and “Cortisol”; Mayo Clinic News Network, “Getting to the 'Heart' of Sleep” and “Strategies to Prevent Heart Disease.”