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Sleep and Heart Health

Contributor: Meagan Wasfy, MD, MPH
8 minute read
A man sleeping

In 2022, the American Heart Association (AHA) added sleep to their checklist of health and lifestyle factors, now called Life’s Essential Eight, which are key for heart health. The AHA now recommends that adults get 7 to 9 hours of sleep a night to prevent heart disease.

“Evidence shows that maintaining healthy levels of sleep has an important impact on cardiovascular health,” explains Meagan Murphy Wasfy, MD, MPH, a Mass General Brigham cardiologist. Dr. Wasfy cares for patients at Massachusetts General Hospital. Learn more about how sleep affects heart health, and how improving one can also benefit the other.

Can lack of sleep cause heart problems?

"We know that not meeting the recommendation for enough sleep is linked to higher rates of cardiovascular disease, including coronary artery disease and stroke. It can also affect risk factors like high blood pressure or hypertension, diabetes, obesity, and inflammation, which we know are absolutely vital for cardiovascular health,” Dr. Wasfy says.

“Broadly speaking, lack of sleep affects the body in two ways,” says Dr. Wasfy. Both biological and lifestyle factors are affected:

  1. Biological factors. Research has shown that not getting enough sleep can increase your levels of cortisol, which is a hormone that can indicate the body is under stress. Chronic stress can increase your blood pressure and heart rate, forcing the heart to work harder. Lack of sleep can also increase the risk of mood disorders like depression and anxiety, which can also affect the heart.

  2. Lifestyle factors: “We know that poor sleep can directly impact the parts of the brain that control hunger. By increasing fatigue, poor sleep can also impact other lifestyle factors like choosing healthy foods and getting adequate amounts of exercise,” Dr. Wasfy says.

Once your sleep is thrown off, it can cause a cycle that’s hard to get out of. “We know, for example, having good levels of physical activity can improve your sleep. But on the flip side, if you’re not sleeping well and you’re not as inclined to exercise because you’re tired, it creates a negative feedback loop. It can affect how well you sleep the next night, and so on,” Dr. Wasfy says.

Does lack of sleep affect heart rate?

As your body rests during sleep, your blood pressure and heart rate lower, but this can vary from person to person. When you’re dreaming, your heart rate can also increase depending on the content of your dreams. For example, if you’re having a nightmare, it may increase. 

Wearable fitness trackers and smart watches can provide you and your doctor with more data on your heart rate while sleeping. But they haven’t been tested for accuracy, so the information they provide should be used cautiously. 

“We don’t have strong outcome data that sleep quality scores from wearables available to the public are something we need to evaluate and manage,” says Dr. Wasfy. “Instead, we can be curious about these metrics and think about how to incorporate them for long-term health optimization.”

Sleeping heart rate by age

Sleeping heart rate varies by age, with children having faster heart rates than adults. An average adult sleeping heart rate is between 40 to 60 bpm (beats per minute), while kids will be higher. 

How can you get better sleep?

Following good “sleep hygiene” rules of thumb can help improve your sleep.

To get better sleep:

  • Establish a routine and be consistent: Try to go to bed and wake up at the same time each day, even weekends.

  • Create a calm, sleep-friendly environment: Try using black-out curtains, an eye mask, or a white noise machine, and keeping your room at a cooler temperature.

  • Avoid electronics: Don’t use them in bed or the hours before bedtime and silence any notifications.

  • Exercise regularly: Studies show that regular exercise helps improve sleep.

  • Don’t eat right before bed: Research shows that heavy meals before bedtime can affect sleep.

  • Limit nicotine, caffeine, and alcohol. These substances have been shown to disrupt sleep in different ways. They should be avoided, especially in the hours before bedtime.

  • Get morning light exposure: “There’s research showing that daily exposure to light, particularly in the morning, can help set your circadian rhythm in the right direction,” Dr. Wasfy says. The circadian rhythm is your body’s inner clock and can affect your sleep/wake cycle.

Some people may have a harder time following these rules of thumb, especially those who work shifts during nighttime hours. “If we think about applying this recommendation equally across all humans, there are higher risk groups of individuals, where sleep disruption is part of their job description. Or they have a lot of life stressors, or don’t have a safe place to get that sleep. There’s a lot we can do to try and improve those risks,” says Dr. Wasfy.

Treating sleep disorders is just as essential as any medical therapy we provide.

Meagan Wasfy, MD, MPH
Mass General Brigham

Sleep disorders and heart health

If you’re still having a hard time sleeping after following sleep hygiene rules, or routinely wake up exhausted after spending 7 to 9 hours in bed, talk to your primary care provider or cardiologist, if you have one. They might recommend seeing a sleep specialist to be tested for a sleep disorder.

“With sleep apnea, there’s a period of no breathing because the airflow has stopped. The oxygen levels dip, the blood pressure surges, and the heart rate can dip. If it’s happening many times over night, over many nights of sleep in someone’s lifetime, it can really add up,” Dr. Wasfy says. 

The good news is that both insomnia and sleep apnea are treatable.  Insomnia can be treated with medication and cognitive behavioral therapy. Sleep apnea is treated with lifestyle changes like losing weight and getting more exercise, or with interventions like medication or a CPAP machine, which helps keep airways open. “Treating sleep disorders is just as essential as any medical therapy we provide,” says Dr. Wasfy.

Meagan Wasfy, MD, MPH