The Important Role of Restorative Sleep in Heart Health

By:
Kim Butrum, MS, RN, GNP
Senior Vice President, Clinical Services

As we think of ways to improve our cardiovascular and brain health during February, “Healthy Heart month,” restorative sleep is one area that is important for us to focus on.  Sleep is not just “rest”—it is an active repair time for the heart, blood vessels, and brain. Chronic poor sleep increases the risk for hypertension, heart disease, memory loss, and dementia.

Research has shown that restorative sleep is vital to healthy brain function as it is at that time that our brain gets rid of the byproducts of metabolism that can be toxic to other brain cells.

In fact, evidence from the Framingham Heart Study ⁽¹⁾ reported that loss of restorative deep sleep over time is associated with a higher risk of the development of dementia. This is why getting enough deep sleep is now considered a modifiable protective lifestyle factor in the development of dementia.

 The Sleep Heart Health Study ⁽²⁾ found that reduced slow-wave (restorative) sleep was linked to the development of hypertension in adults followed over time, even after accounting for other confounding factors.

Hypertension is acknowledged to be a significant risk factor not only for heart disease but also for the development of dementia. In fact, according to the Sprint-MIND study ⁽³⁾ a blood pressure of less than 130 mmhg is ideal for brain health and can help prevent MCI and dementia.  

Many people use medications to sleep, however it is much better to use non-pharmacological treatments and good sleep hygiene to assist with sleep.  

Here are some practical tips to improve your level of restorative deep sleep:

1. Keep a consistent sleep schedule: Going to bed and waking up at the same time every day helps regulate the body’s internal clock. Consistency can lead to longer and more stable periods of deep sleep.
2.  Protect the first half of the night: Noise and light can fragment sleep without fully waking a person—yet still reduce deep sleep.  Deep sleep occurs mostly in the early part of the night. Late bedtimes, frequent early-night awakenings, or stimulating activities before bed reduce the amount of restorative sleep.
3. Consider discomfort:  Pain is one of the most common reasons deep sleep is interrupted. Even low-level discomfort can prevent the body from staying in restorative sleep stages.
4. Encourage daytime light exposure and activity: Bright daylight exposure and physical movement during the day strengthens one’s nighttime sleep drive and increases deep sleep.  Morning sunlight has been shown to be particularly beneficial.
5. Limit caffeine and alcohol in the evening: Caffeine reduces deep sleep even when people feel they “sleep fine.” While alcohol may cause drowsiness, it also disrupts deep sleep and REM sleep later in the night.

Finally, stress can increase the level of cortisol in your body which can increase your heart rate and then interfere with deep sleep. So while it can be difficult to do, if you are not sleeping at night, get up and read a book, listen to quiet music, or do relaxation exercises but most importantly try not to pick up your phone and start scrolling, and hopefully soon you will be on your way to a night of restorative sleep.

References

1. Himali JJ, Baril A, Cavuoto MG, et al. Association Between Slow-Wave Sleep Loss and Incident Dementia. JAMA Neurol. 2023;80(12):1326–1333. doi:10.1001/jamaneurol.2023.3889

• Javaheri, S., Zhao, Y. Y., Punjabi, N. M., Quan, S. F., Gottlieb, D. J., & Redline, S. (2018). Slow-Wave Sleep Is Associated With Incident Hypertension: The Sleep Heart Health Study. Sleep, 41(1), zsx179.

• SPRINT MIND Investigators for the SPRINT Research Group; Effect of Intensive vs Standard Blood Pressure Control on Probable Dementia: A Randomized Clinical Trial. JAMA. 2019 Feb 12;321(6):553-561.

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