Sleep and Heart Health

Sleep is now a heart health metric

The American Heart Association's Life's Essential 8 lists the key measures of cardiovascular health: diet, physical activity, nicotine exposure, sleep, weight, cholesterol, blood sugar and blood pressure. Sleep was added in 2022, with 7 to 9 hours a night considered optimal for adults.

What happens during sleep

During healthy non-REM sleep, heart rate and blood pressure fall. This night-time dip gives the cardiovascular system a period of lower strain. Short or fragmented sleep reduces that dip and keeps stress hormones and the sympathetic nervous system more active.

Short sleep and blood pressure

Regularly sleeping less than 7 hours is associated with higher risk of high blood pressure, coronary heart disease, heart attack and stroke. The NHLBI lists heart disease and high blood pressure among the health effects of sleep deficiency. Irregular sleep schedules have also been associated with worse cardiovascular markers.

Sleep apnea and the heart

Obstructive sleep apnea causes repeated breathing pauses, drops in oxygen and surges in blood pressure throughout the night. It is strongly associated with high blood pressure, including blood pressure that is hard to control with medication, as well as atrial fibrillation, heart failure and stroke. Many people with sleep apnea do not know they have it. Treatment, most commonly with CPAP, can improve sleepiness and quality of life, and in some people helps lower blood pressure.

Signs worth acting on

Talk to your doctor about a sleep evaluation if you have:

• Loud snoring, gasping or choking at night, or breathing pauses noticed by someone else
• High blood pressure that is difficult to control
• Atrial fibrillation or other heart rhythm problems
• Daytime sleepiness, morning headaches or unrefreshing sleep

Heart-healthy sleep habits

• Aim for 7 to 9 hours per night.
• Keep consistent sleep and wake times.
• Limit alcohol, especially in the evening.
• Do not smoke or vape nicotine.
• Stay active and maintain a healthy weight.
• Treat sleep apnea if diagnosed and use your therapy consistently.