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Women told to make sure they get enough sleep or risk a stroke or heart attack

By Vera Salnitskaya
24 August 2015

Expert warns females should take special care, especially once they reach menopause.

The Novosibirsk professor's research involving male sleeping patterns and their link to heart attacks and strokes was presented European Society of Cardiology conference in Croatia last month. Picture: Vera Salnitskaya

Professor Valery Gafarov also highlights how both sexes in Russia  were prone to cardiovascular disease in periods of social tension in 1988, 1994, and 1998, suggesting the same may occur due to the current economic crisis. 

The Novosibirsk professor's research involving male sleeping patterns and their link to heart attacks and strokes was presented European Society of Cardiology conference in Croatia last month, leading to significant coverage around the world. Now he has told The Siberian Times that women, too, while biologically and socially better protected than men from the impact of lack of sleep on their health, also face acute risks. 

His research indicates that doctors should warn that sleep disorders are a major risk factor for cardiovascular problems, alongside other frequently cited factors - smoking, lack of exercise and poor diet.

'We run research on women, too,' he said, saying some results were presented to a  conference this year on Women's Mental Health in Tokyo. 'There is the same tendency: those who have a sleeping disorder are 2-to-4 times more likely [to suffer heart attack and stroke].

'Women are 2-3 times less likely to develop a heart attack at a young age than men. However, they are much more likely to develop it once they reach menopause. A dramatic increase in the incidence of myocardial infarction occurs 10 years later than men.

He emphasised: 'Women have the same sleeping disorders as men - and even more of them. However, female hormones act as strong antioxidants and protect women while they are fertile. In a way, it's a sort of protection system that men don't have. A woman needs a good cardiovascular system to carry a child, good kidneys and so on, and hormones are adapting these organs for increased tension.'

Sleep to beat infarct

'Women are 2-3 times less likely to develop a heart attack at a young age than men. However, they are much more likely to develop it once they reach menopause.' Picture: Vera Salnitskaya

Crucially, the female ability to express her feelings, and have heart to heart conversations, can prevent problems for women. This is one of the types of social support.

'If we are to talk about psychosocial factors, there is such thing as social support which reduces the adverse psychosocial factors. It's quite well spread in women. It is an emotional release that reduces stress. You chat to a friend and it feels better. Men don't have it. Our men are not very regular at going to psychologists. Although there are attempts to address  this, there is lack of awareness and men decline such opportunities.'

He emphasised:  'Sleep is a very important physiological condition. A sleeping disorder affects all the biological processes. It breaks all the systems.'

The professor  warned: 'This problem can't be sorted by medication. It seems easy, take a pill and fall asleep. But that is an addiction and acts as a drug. Besides it doesn't reduce anxiety and doesn't address the cause of stress.' He is adamant that people should take greater care with their sleep.

'Healthy sleep should last no less than seven hours and no longer than nine because shorter and longer sleep are equally bad. There are two phases of sleep, quick and slow. The quick one is called a period of vegetative storm when an individual is going through the events of the day behind. During slow phase the body rests. 

'There are 3 or 4 cycles, but if you wake up during one of these phases, you develop cycle problems and it becomes difficult to fall asleep which affects quantity and quality of sleep. 

Sleep to beat infarct

'Healthy sleep should last no less than seven hours and no longer than nine because shorter and longer sleep are equally bad.' Picture: Vera Salnitskaya

'You're sleeping 5 or 10 hours instead of 7. The healthiest sleep is related to biological rhythms. You wake up with sunrise and fall asleep with sunset.' The social tensions in Russia - exactly as in other countries - has a direct impact on health, he said. 

'It turned out that the heart attack is an indicator of social tensions in a society and as soon as the tensions rise, the number of heart attacks increases,' he said.

If we take Russia, we can see the following periods led to an increase:

'1988 - that's when perestroika began (under the rule of Mikhail Gorbachev). 1994 - the crisis involving the Russiam parliament at the end of 1993, and 1998 - the financial crisis. These phenomena affected all sectors of the population. It is possible that there may be an increased incidence of myocardial infarction in this year, due to the economic crisis.'

He stressed such a pattern is by no means restricted to Russia.

'I want to say that Russia is no exception. In previous years, we have seen the growth of IM (myocardial infarction) in the former socialist countries during their decay (Hungary, Czechoslovakia, Poland, Bulgaria, etc.), during the war in former Yugoslavia, in the countries formerly part of the USSR (Lithuania, Latvia, Estonia, Moldova, Georgia. etc). 

'But there are no reasons for this phenomenon. We found them. I think that if now in Greece and Ukraine to carry out monitoring of public health, we would find exactly the same phenomenon of increasing incidence of myocardial infarction.'

Professor Gafarov

Aged 63, Professor Gafarov is head of the laboratory psychological and sociological problems of therapeutic diseases at the R&D Institute of Therapy and Preventive Medicine in Novosibirsk. Picture: Vera Salnitskaya

Aged 63, Professor Gafarov is head of the laboratory psychological and sociological problems of therapeutic diseases at the R&D Institute of Therapy and Preventive Medicine in Novosibirsk.

'Our Institute remains the only center in Russia working on the programme of the World Health Organisation (WHO),' he said. 'We have been working on international programme of WHO since 1977, the first international WHO programme, which was launched in Novosibirsk was the programme Register of Acute Myocardial Infarction and is currently ongoing. 

'I ran this programme, and for a long period of time have led it. It aimed at monitoring the health of the population. We are also involved in the treatment, and in issues of diagnostics, effectiveness of medical care and its correction. Apart from that, in our institute is undertaking genetic studies of therapeutic diseases, studied issues of Arctic Medicine - that is,  how the Arctic climate is affecting health.

'We have been monitoring health for a long time. We are not working with the ill, we work with the residents of a particular administrative unit, namely the public. We pick people, aged 25 to 64, randomly and don't know if they're healthy or ill, and then run a complete health check. We have very resourceful research equipment.

'We find out if he or she has any diseases, what are the risk factors affecting them and as a result make a conclusion on the health of the Russian population.

Sleep to beat infarct

'We pick people, aged 25 to 64, randomly and don't know if they're healthy or ill, and then run a complete health check.' Picture: Vera Salnitskaya

'Back in 1977 we launched the  WHO health monitoring programme Register of acute MI.  It is the most severe pathology that contributes to the majority of deaths.

'Cardiovascular diseases contribute to 48% of total deaths, and 74% of these contribute to ischemia or heart attack. After having launched this programme, we discovered that we were one of the first places in the world in terms of number of heart attacks. 

'Unfortunately, the largest increase in the incidence of myocardial infarction was observed between the ages of 45 and 54,  compared to age 35-44 years. At the same time, in countries such as Germany, Sweden, Italy,  this jump occurs at the age of 70.'

'For 38 years (1977-2014) , the incidence and mortality from myocardial infarction is consistently high, with the exception of those years when there were high levels of social tension (1988, 1994, 1998, and 2008) - the increase of morbidity and mortality from myocardial infarction;  reduced morbidity and mortality from myocardial infarction in 2006-2007, 2010-2012 yr. (years of stable development of society)

'Due to the fact that we employ the WHO register, we were the first to identify the causes of high mortality in Russia in 1994. The reason for high mortality were cardiovascular diseases associated with social tensions and not the consumption of alcohol as some authors have claimed. 

'On this topic was published one of the first our monograph Epidemiology and prevention of chronic non-communicable diseases for two decades and in the period of socio - economic crisis in Russia, 2000. Where we all exposition. 

'Apart from that, another programme WHO - MONICA (Multinational Monitoring of Trends and Determinants of Cardiovascular Disease) - was launched across 28 countries. We were one of the among 39 centres across the globe running it.

MONICA

'Apart from that, another programme WHO - MONICA (Multinational Monitoring of Trends and Determinants of Cardiovascular Disease) - was launched across 28 countries. Picture: MONICA

'It turned out that we have a high level  traditional risk factors  - hypertension, overweight, high cholesterol, smoking'.  

There were three screenings - in 1984, 1988 and 1994 - and 'typical risk factors were still there although there was a dramatic rise in the number of cases and mortality rate MI. 

At the time we couldn't understand the reasons behind such rise.

'Alongside MONICA, we ran a sub-programme, MONICA ~ Psychosocial. And when we realised that there were no dynamics in traditional  factors [contributing to the development of cardiovascular diseases], we looked at the findings of MONICA Psychosocial. It turned out that the number of psychosocial factors - anxiety - almost increased two fold. 

Anxiety as a psychosocial factor, along with others, reflects the level of social stress in the population.

'It turned out that psychosocial factors are 3-4 times more important in the development of diseases and mortality compared to conventional factors. The number of negative affective conditions, or so-called psychosocial factors - anxiety - have doubled. Instead of a usual 35%, in 1988 it reached 45% and 54% in 1994.

'We collected data on psychosocial factors previously but we didn't pay that much attention earlier. But we started analysing them and it turned out that psychosocial factors contribute to 50% of all cases and traditional factors [hypertension, overweight, high cholesterol, and smoking ] contribute to about 20% of the cases.'

He said: 'When observing healthy people for 16 years, who were found with sleeping disorders, the risk of heart attack and stroke are 2-4 times higher than those who did not have these sleeping disorders.'

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