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Are sleeping pills safe if you have heart disease? Sufficient sleep is critical for heart health, but sleep aids require caution and a physician's advice.

Poor sleep is common among older adults: They're more likely to suffer from age-related conditions that disrupt sleep, and also tend to spend more time in light sleep. That doesn't mean you should put up with the problem or dismiss it as one of the perils of aging, however, says Leo Pozuelo, MD, staff psychiatrist and associate director of the Bakken Heart Brain Institute at Cleveland Clinic.

"Even if many aspects of sleep--including why exactly we need it--remain a mystery, research suggests that not sleeping enough or sleeping badly runs counter to the body's internal clock, disrupting every physiologic function in the body," he notes.

But while you might think that taking sleeping pills to achieve restful sleep might benefit your health, you're wrong. A 2010 study (Canadian Journal of Psychiatry, September) showed that people who take sleeping pills are one-third more likely to die prematurely than those who don't take them.

Sleeping pills and the heart

The study analyzed 12 years of data on more than 12,000 Canadians, and accounted for factors that can affect longevity, including alcohol and tobacco consumption, physical health, physical activity and depression. The pills used ranged from over-the-counter antihistamines to prescription-only drugs, such as diazepam (Valium). Mortality rates were found to be significantly higher--36 percent--among sleeping pill users and those taking tablets to ease anxiety.

"Sleeping pills--both prescribed and 'herbal' options--can affect reaction time, and cause poor coordination and grogginess, which raise the odds of falls," says Dr. Pozuelo. "It's also possible they also may suppress the respiratory system, which could aggravate breathing problems during sleep, particularly if you have a heart problem." He adds that some OTC sleep medications also contain the antihistamine diphenhydramine (for example, Tylenol PM, Advil PM, and many own-brand sleep aids) which can trigger atrial fibrillation, a type of heart arrhythmia common in adults age 65 and older.

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Getting restful sleep

Where the heart is concerned, poor sleep has been linked separately with high blood pressure, atherosclerosis (narrowed arteries), heart attack and stroke, as well as diabetes and obesity, both of which also impact heart health. Studies suggest that regularly getting less than seven hours of sleep a night is associated with an increased risk of heart disease.

Dr. Pozuelo says it isn't entirely clear why poor sleep takes its toll on our hearts. "It could be that lack of sleep causes stress, and this increases blood levels of the stress hormone Cortisol, which can raise the risk of coronary artery disease over time," he explains. "Studies have shown that people who sleep badly have higher levels of inflammatory chemicals in their blood, and it also may be that shorter sleep periods prevent blood pressure from dipping naturally overnight, which may provide health benefits for those who do sleep well."

If you are sleeping poorly, speak with your doctor about how you can alleviate what is disturbing your slumber. "This is especially important if you think you may have sleep apnea, which occurs when the muscles in the throat relax during sleep, reducing the body's oxygen supply," Dr. Pozuelo says. The condition is thought to cause about 38,000 cardiovascular deaths annually. Symptoms include snoring, shortness of breath, gasping, or choking that wakes you from sleep, and excessive daytime drowsiness with no apparent reason.

A short course of sleeping pills may still be an option, under your doctor's supervision, and they can be useful for breaking a pattern of night-waking, Dr. Pozuelo adds.

"Address 'sleep hygiene' too--establish a regular sleep-wake cycle, schedule daytime naps as early as possible, and avoid caffeine and alcohol in the evenings, as both are stimulants that may keep you awake." Ear plugs, sleep masks and white noise machines also can help to create a dark, peaceful atmosphere conducive to sleep.

RELATED ARTICLE: WHAT YOU CAN DO

To help improve your sleep

* Exercise daily for 30 to 60 minutes, preferably in the morning. Evening exercise may interfere with your sleep.

* Consult with a sleep specialist, who may prescribe an overnight study to look for conditions such as sleep apnea.

* Make sure the temperature in your room at night isn't too warm, and consider a new pillow or mattress if you find yourself unable to get comfortable at night.
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Title Annotation:DRUG WATCH
Publication:Heart Advisor
Date:Mar 1, 2011
Words:706
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