There are 50-60,000 miles of arteries in your body, all lined by a fascinating layer called the endothelium. A healthy endothelium is a healthy body. On top of the endothelium is an even more important structure called the glycocalyx.
As a preventive cardiologist, I work with patients who want to improve their health and lengthen their lives. Many of them have major risk factors for heart disease; others already have full-blown heart disease or have experienced major cardiac events such as heart attack, angina, or bypass surgery. These people want to change their future health; they see the writing on the wall, and they don’t like what it is telling them.
The Four Big Lifestyle Factors
Traditionally patients who want to improve their heart health have received four main suggestions from their doctors: Eat a healthy diet, get more exercise, quit smoking, and enjoy moderate alcohol intake. Plenty of research backs up these four pillars of advice: Large studies have found that making improvements in these four areas lowers the chance of dying of heart disease by 67 percent.
Why Sleep is Lifestyle Factor #5
Researchers are starting to recognize that there should be five recommendations on that list, not just four. They’re discovering that getting enough sleep is a powerful health protector as well. When researchers include adequate sleep in their studies as a fifth cardio-preventive behavior change, they find that it lowers the chance of dying from heart disease even more: Adding a good seven hours a night of sleep in addition to making positive changes in diet, exercise, smoking, and alcohol intake lowers the chance of dying of heart disease by a whopping 83 percent.
When that news started coming out, doctors began tagging sleep onto their list of recommended health behavior changes. But I don’t think sleep belongs at the bottom of the list — I think it should be at the top! I believe that getting enough sleep — at least seven to eight hours per night for most people — is the most important health behavior change you can make to improve your cardiac health and your overall health.
That’s right: I recommend that if you make just one change to benefit the health of your heart and the rest of your body, that change should be getting a good seven hours of sleep each night. Sleep is such an effective way to boost health that I make it my no. 1 health recommendation. Getting the sleep you need offers a big dose of protection from heart disease — the number one killer in the United States — as well as many other health threats, from cancer to diabetes to depression.
Sure, I’d prefer that everyone make all of the Big Five lifestyle changes. But if I could only choose one of those, I’d pick sleep, because when you are well-rested, everything else in life is easier. When you get the sleep you need, you have more power to make the right choices about what you eat and drink. You have more energy to exercise. And you have the resilience you need to kick bad habits such as smoking and overeating. It all comes down to this: When you’re well-rested you can do almost anything. And when you’re chronically exhausted, everything in life is more difficult. You simply can’t be fully healthy without enough sleep.
The Kahn Center Approach
A sleep tracker like the Oura Ring or the Whoop band can be of great value to track sleep quality and quantity. Home sleep studies are used liberally if there is any question of snoring or apnea. Simple apps like Snore Lab on a smart phone may be of value too. Medication apps like Calm or Headspace help many. A single or mixture of sleep aids are recommended for most patients. At the Kahn Center we use the only plant based melatonin available that also has an extremely high antioxidant (ORAC) value to benefit sleep even further. Many patients choose full-spectrum hemp oil products, often combined with the plant based melatonin. Other sleep aids like GABA and glycine are considered. Patients are never prescribed Rx medication for sleep as these may have very concerning side effects. All the good sleep hygiene tips such as a dark room, blue light blocking glasses, white noise, and mouth taping are considered. If the first strategy you choose does not work, do not give up. Keep on experimenting with your sleep until you master sleep and it does not master you.
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