Sleep reduces odds of arterial calcification

Unwittingly putting family before fortune in last week’s column, I became figuratively but totally involved in the literal struggle of our family loved ones in Tulsa and Detroit as they encountered and were captured by the latest norovirus cross-country sweep.

Thus, some 40 family members were struck by this devious gut-wrencher. However, all recovered nicely, occasionally after some ER fluid replacement, but without damage to anything but their New Year’s enjoyment and, perhaps, an occasional kiddie – even adult – undergarment.

My distant involvement, however, brought me directly to the production of last week’s refresher column on the norovirus but also to the neglect of my faithful readers’ personal New Year’s position and wishes.

Therefore, and hopefully, if it is not too late, please accept my sincere wishes for your 2009 year of warmth, companionship and ever-improving well-being.

Now, after nourishing the soul, on to the heart of this column. A group of astute physicians – working in a broad scope of national medical communities – have found a robust and novel association between observed sleep duration and the risk of coronary artery calcification.

Seems weird, doesn’t it? But they’ve got the facts.The results of their investigation appear in the Dec. 24 edition of the Journal of the American Medical Association – and it follows, couched in this short cardiovascular wrap:

Coronary artery calcification is the precursor of a horrible parcel of coronary events. As the calcified plaques build, circulation around our heart muscles crumble, and we end up with occlusions, heart attacks, stents, bypass procedures, heart failure, cardiac arrests and, often, death.

We all know this and about the restrictions it imposes upon lifestyle and upon life itself. It is, among our senior fold, our greatest crippler and the leading single cause of our death. Known factors that lead to coronary calcification and its future catastrophes include being male, age, obesity, lifestyle, hypertension, a destructive lipid profile, glucose intolerance, tobacco use and a low education level.

Added to this sad contributory litany recently, and we have just as recently talked about it together, has been chronic inflammation as exemplified by chronic gingivitis – an inflammatory disorder that often attacks our gums.

There are, of course, other significant inflammatory disorders and sources within us, but gingivitis is a very common, often overlooked and securely treatable inflammatory source.

Now, to sleep – not us and not now – just to talk about it. As but one striking finding of the study mentioned above, we learn that the regular loss of one hour of normal sleep time – one hour – increases our arterial calcification odds by 33 percent!

This is a harsh reality to absorb and to believe, but the multicenter study from which this and other sleep/artery calcification findings were generated has been very closely controlled.

Involved in this study were 495 middle-aged men and women who were under observation for up to 20 years in their home environment for this and other studies.

Potential confounders such as age, race, sex, education, and tobacco status, along with other mediating factors such as blood pressure, BMI, blood fats, inflammatory markers, diabetes, alcohol habits, depression, hostility and more were all study-included, evaluated and accounted for.

Sleep, in this research, was regularly monitored by a wrist-attached actigraph – a device which faithfully measured sleep duration, quality and fragmentation. This is probably the first study in which sleep was accurately and routinely monitored in a home environment.

Besides the startling finding mentioned earlier, this extensive work revealed an average 12.3 percent arterial calcification rate in the total study group – a rate that was significantly reduced with longer sleep duration.

Other sleep measurements including sleep depth and the presence of apneic (obstructed breathing) episodes, could not be correlated with the increased calcification – although further study is asked for and is needed in order to completely evaluate these common sleep problems.

Meanwhile, don’t lose any of your own precious sleep worrying about it. Remember what a difference an hour makes, and Shakespeare’s declaration that sleep knits up the raveled sleeve of care!

Clearly, we are approaching a more intensive overview of our lifestyle in all of its aspects, and the related and resultant establishment and progression of our No. 1 petard – a destructive instrument upon which we have hoisted ourselves by a seemingly endless set of body and societal pernicious conditions all harvested in our gradual heart crippling and, eventually, our demise.

This is an area of cardiovascular protection and control which is begging for our continued study – study which must eventually extend our healthy existence into a new vista of potentially golden years.