Friday, June 12, 2009


Sleep is often undervalued as an important part of health maintainence. Sleep deprivation for short periods maybe ok, but certainly, chronic insomnics do face a health pproblem of cardiovascular upsets, general body malaise and poor immunity. The fact that we have 8 hours of rest at night allows the body to re-charge ( everyone knows that ). In our clinic ( which is obviously a CVS clinic ), I make it a point to ask about sleep in all my patients, many of whom are suffering from hypertension and sometimes even frequent " flus ". I have noticed for awhile now that poor bloop pressure control is often due to poor sleep patterns and insomnia.
Poor sleep patterns could be due to emotional stress ( a simple word for this is worry ), poor personal habits, age and maybe also a poor environment. When we do not get enough sleep, the body metabolism has no chance to rest and our catecholamine levels, remain chronically high. It is well shown that chronic lack of sleep is associated with high baseline catecholamine levels. And chronically high catecholamine levels drives sleeplessness. This is probably the reason why people who do not sleep well develop hypertension.
This is now confirmed in a study out of the U. of Chicago, by Dr K Knutson, and group published in the June 8th issue of the Archives of Internal Medicine. Their observation is part of the CARDIA study. In this sub-study, Dr Knutson studied the sleep pattern of 578 patients ( part of the CARDIA group ) who have no hypertension. He have them wear a wrist activity sensor, so that he can measure their wrist motions during sleep. Less motion more sleep and more motion less sleep. He followed them up for 5 years, and noticed that after 5 years, those with less sleep were one third more likely to develop hypertension. Thus lending credence to our theory that sleep affects blood pressure. That may also explain why senior citizens are more prone to hypertension and other CV events, as they have a higher incidence of insomnia.
Doctors, if your patient's BP is not easily controlled and seem to be bobbing up and down, check their sleep pattern. As a corollary, it is also wellknown that sleep apnea is associated with a higher incidence of hypertension.
It is therefore important in our healthy lifestyle campaign to inculcate a healthy sleep pattern, which may require a healthy and restive mind, at peace with itself.

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