Monday, December 14, 2009
Less Sleep and heart Attack Course Dealth
Dr Nik Omar and Dr Nik Aziz at A Seminar organized by Malaysian Medical Association, MMA at Kuala Lumpur.
Subject: Sleep and Heart Attacks
What killed Ranjan Das and Lessons for Corporate India
A month ago, many of us heard about the sad demise of Ranjan Das from Bandra, Mumbai. Ranjan, just 42 years of age, was the CEO of SAP-Indian Subcontinent, the youngest CEO of an MNC in India. He was very active in sports, was a fitness freak and a marathon runner. It was common to see him run on Bandra's Carter Road. Just after Diwali, on 21st Oct, he returned home from his gym after a workout, collapsed with a massive heart attack and died. He is survived by his wife and two very young kids.
It was certainly a wake-up call for corporate India. However, it was even more disastrous for runners amongst us. Since Ranjan was an avid marathoner (in Feb 09, he ran Chennai Marathon at the same time some of us were running Pondicherry Marathon 180 km away), the question came as to why an exceptionally active, athletic person succumb to heart attack at 42 years of age.
Was it the stress?
A couple of you called me asking about the reasons. While Ranjan had mentioned that he faced a lot of stress, that is a common element in most of our lives. We used to think that by being fit, one can conquer the bad effects of stress. So I doubted if the cause was stress.
The Real Reason
However, everyone missed out a small line in the reports that Ranjan used to make do with 4-5 hours of sleep. This is an earlier interview of Ranjan on NDTV in the program 'Boss' Day Out':
Here he himself admits that he would love to get more sleep (and that he was not proud of his ability to manage without sleep, contrary to what others extolled).
Last week, I was working with a well-known cardiologist on the subject of ‘Heart Disease caused by Lack of Sleep’. While I cannot share the video nor the slides because of confidentiality reasons, I have distilled the key points below in the hope it will save some of our lives.
· Short sleep duration (<5 or 5-6 hours) increased risk for high BP by 350% to 500% compared to those who slept longer than 6 hours per night. Paper published in 2009.
As you know, high BP kills.
· Young people (25-49 years of age) are twice as likely to get high BP if they sleep less. Paper published in 2006.
· Individuals who slept less than 5 hours a night had a 3-fold increased risk of heart attacks. Paper published in 1999.
· Complete and partial lack of sleep increased the blood concentrations of High sensitivity C-Reactive Protein (hs-cRP), the strongest predictor of heart attacks. Even after getting adequate sleep later, the levels stayed high!!
· Just one night of sleep loss increases very toxic substances in body such as Interleukin-6 (IL-6), Tumour Necrosis Factor-Alpha (TNF-alpha) and C-reactive protein (cRP). They increase risks of many medical conditions, including cancer, arthritis andheart disease. Paper published in 2004.
· Sleeping for <=5 hours per night leads to 39% increase in heart disease. Sleeping for <=6 hours per night leads to 18% increase in heart disease. Paper published in 2006.
For lack of space, I cannot explain here the ideal sleep architecture. But in brief, sleep is composed of two stages: REM (Rapid Eye Movement) and non-REM. The former helps in mental consolidation while the latter helps in physical repair and rebuilding. During the night, you alternate between REM and non-REM stages 4-5 times.
The earlier part of sleep is mostly non-REM. During that period, your pituitary gland releases growth hormones that repair your body. The latter part of sleep is more and more REM type.
For you to be mentally alert during the day, the latter part of sleep is more important. No wonder when you wake up with an alarm clock after 5-6 hours of sleep, you are mentally irritable throughout the day (lack of REM sleep). And if you have slept for less than 5 hours, your body is in a complete physical mess (lack of non-REM sleep), you are tired throughout the day, moving like a zombie and your immunity is way down (I’ve been there, done that L)
Finally, as long-distance runners, you need an hour of extra sleep to repair the running related damage.
From Dr Surjit Singh Makker, India
Posted by Info Sihat at 1:11 AM