Tim Russert, Coronary Artery Disease, and Sleep

The news of celebrated newsman and Meet the Press moderator Tim Russert's sudden passing last Friday took many people by surprise. He was only 58 years old; even his own father, who became the basis for Tim's last book, has outlived him.

By Monday morning, the stories about this prominent and beloved man's life were still circulating, and talk about how or why he died so young started brewing stronger. People began asking about heart attack avoidance. Newsweek magazine featured a story about the "science of sudden cardiac arrest".

I heard Dr. Nancy Snyderman, NBC's chief medical editor, answer general questions about Tim's previously diagnosed health problem: coronary artery disease. He was doing everything right to manage his disease, which included occasional stress tests to check out his heart (the last of which he passed on April 29), medication, daily exercise (he had used a treadmill the morning he died), and watching his diet. His blood pressure and cholesterol were "well-controlled." So what went wrong?

With the buzz about terrorist attacks and cancer running routinely in the media, we often forget that heart disease is the number one killer for both men and women.

That's right: we're all more likely to have a heart attack than be struck by a missile or get cancer.

We do have an impressive array of technology, tests, and drugs today to help detect, treat, manage, and combat heart disease. But for some, as was the case for Tim, it's too late by the time the "big one" hits.

Sudden cardiac arrest accounts for 310,000 deaths in America every year, or 850 a day--more than those caused by breast cancer, lung cancer, stroke, and AIDS combined. According to his own personal physician, his particular heart disease resulted in hardening of his coronary arteries. A fresh clot ruptured in Tim's left anterior descending coronary artery, causing the fatal heart attack. The autopsy also revealed that he had an enlarged heart.

The risk factors for heart disease are well-documented. They include high cholesterol, high blood pressure, diabetes, being overweight, a sedentary lifestyle, and tobacco abuse. Russert apparently had these risk factors under control (I don't believe he was a smoker). But he did have a very busy, over-scheduled career that had him juggling a stressful load of responsibilities. He may not have viewed his life as "stressful" because he loved what he did so much, but his body no doubt must have been crying out for a respite. Sometimes you'd see him fervently commentating into the wee hours of the night during the peak of a political campaign or election, only to see him again on television a few hours later that next morning. As if he never went to bed.

He was indeed a passionate man, dedicated to his thriving career as well as his family. He wasn't the type to take an extended time-out because he couldn't stand being far from his job--even if he sacrificed sleep. I hear that he flew back from Rome early, where he'd been celebrating his son's recent graduation from college, because he wanted to prepare for Sunday's show. He'd gotten just two hours of sleep on the plane before hitting the ground running again at work.

When you've already got coronary artery disease you have to consider more than the obvious risk factors. You have to think about what your body--not necessarily you--need. Otherwise, you could be setting yourself up for an unexpected, asymptomatic, and untimely health problem.

For Tim, coronary artery disease was probably his single biggest risk factor for having a fatal heart attack. Going on little sleep just compounds that--and other--problems. In fact, sleep plays directly into all of the chief risk factors for heart disease. Dr. Snyderman underscored this during her interview: "We are a sleep-deprived nation... The less sleep you get, you're at an increased risk for heart disease."

This is not to say that Tim's untimely death was caused by sleep deprivation or could have been avoided had he given his body proper rest. But it's worth noting that adequate sleep can lower your risk for heart disease and lower some of the risk factors, such as diabetes, obesity, and high blood pressure. In addition, sleep takes the edge out of our stressful lives and helps us restore our bodies for the next busy day.

With all this in mind, I leave you with a new list of things to do to avoid a heart attack.

• Get your cholesterol and blood pressure checked and under control if high


• Watch your girth (women should have a waist no larger than 25 inches around; for men it's 40 inches)


• Be active most, if not all, days of the week


• Quit smoking


• Eat well--a high-fiber, low fat diet


• Get plenty of rest


• Get plenty of rest


• Get plenty of rest

While it's true that we get to "rest in peace" after our time on earth has ended, we need to rest up for a third of that lifespan in order to make it a long one. May Tim's death be a reminder for us all to take sleep to heart.

Related Topics:

• 3 Most Common Heart Attack Symptoms in Women
• 7 Pains You Shouldn't Ignore

Technorati Tags: Tim Russert, sudden death, sudden cardiac arrest, sleep, stress, heart disease
This post is cross-posted at Dr. Breus's blog, The Insomnia Blog.

Insomnia Gets Another Nod

Are you an insomniac? If so, then which kind? The one who flat-out can't ever get to sleep? Or are you the type who fall asleep okay but then has a restless night of tossing and turning as you struggle to stay in dreamland? If you're the latter, there's hope - maybe.

Tossing and Turning - A Genetic Mutation?

I just read about a new study that details how scientists have found mutations in two genes that could clue us into understanding insomnia better. These two genes control electrical excitability in a particular area in the brain known to be involved in sleep.

Of course, the researchers were looking at mice genes, but this could give us a model for understanding how a genetic mutation could partly be to blame for those restless nights. And it could lead us to better treatments in the future. But this would certainly come with a few, shall I say, caveats.

The Causes of Insomnia are Sometimes Hard to Identify

No one who suffers from insomnia likes to hear that it's a "vague" disorder. But it can be hard to pinpoint exactly what's causing it. For some, an underlying medical condition or chronic pain could be the culprit. For others, it could be psychiatric problems like depression, or another sleep disorder like restless leg syndrome (RLS). The other hard part about insomnia is there is no easy "cure." In fact, there may never be. You have to address all the factors that could be channeling the sleeplessness. With stress running our 24-7 lives today, it's no wonder insomniacs are on the rise. But, what if some of those insomniacs could blame (partly or wholly) a mutant gene?

Insomnia Can Have Multiple Sources

I think this opens the conversation up to an even wider playing field. Much wider. This could make this particular area of study fuzzier. To that I pose this question: Assuming you could "turn off" that gene, would someone who has this mutation and insomnia then be insomnia-free? I seriously doubt it. Call me cynical. Sure, some lucky few who could blame all of their sleepless nights on a dysfunctional gene would be just that - lucky. I think we owe the vast majority of insomnia to other causes, from medical to psychological to plain practical (screwing up our sleep cycles by staying up too late, working too long, and taking all of our worries to bed with us).

I challenge anyone who has trouble getting a good night's sleep - no matter what kind of sleep trouble you have - to go on vacation to a truly relaxing place and see if you still have the same sleep issues on the third day of your bliss.

Okay, okay...so a trip to Hawaii or Bora Bora may not be in the cards. Here are my top 5 ways to ensure (not guarantee, but close enough to it!) a good night.

Top 5 Sleep Tips from Dr. Breus

1. Set aside a "power down hour" before bedtime. Stop work. No chores. Do something relaxing like take a warm bath, engage in light reading, or watch TV if that's relaxing for you (avoid the news channels).
2. Go to bed and get up at the same time 7 days a week - no matter what!
3. Schedule in at least 30 minutes of exercise most days of the week. You can break up these minutes into pockets of 10 minutes if you have to. Here's an idea: Expose yourself to bright, morning natural light (a good thing for calibrating the body's natural clock) with a brisk walk before breakfast, then again at lunch, and after dinner.
4. Avoid caffeine after 2 pm in the afternoon. Don't forget hidden sources like soda, and some headache medicines.
5. Adopt some mind-, body-, and sleep-friendly practices like meditation, massage, or yoga.

If you know that pain or a medical condition is affecting your sleep, including meds that you take to treat that condition, speak candidly with your doctor about it. You may have options you have not explored yet to address both the medical condition and your insomnia.

For more ideas, and a specific day-by-day program that you can tailor to your lifestyle to help you achieve restful sleep, I encourage you to grab a copy of my book.

Good night!

This post is cross-posted at Dr. Breus' blog, The Insomnia Blog.

Related Topics:

• WebMD Video: Overcoming Insomnia - One Woman's Story
• The Secret Causes of Insomnia: What Every Woman Should Know About Sleep Problems

Technorati Tags: insomnia, sleep, health and wellness

Debt Got Your Sleep?

Recently, I was reading an article online about the health problems plaguing Americans as worries about mounting debt trigger extreme stress. Rather than blaming things like back pain, headaches, ulcers, depression, and even heart attacks on a specific underlying medical cause, all fingers are pointing toward plain old stress.

Stress is a fact of life...

...and unfortunately debt has also become a fact of life for many of us.

Compounding the problem are recent economic woes as the real estate market sinks, cost of living expenses rise, and just driving the car to the gym or yoga class to work out those stress-related kinks is getting expensive.

According to an index tied to a recent AP-AOL survey, debt stress is 14 percent higher this year. Revolving consumer debt, almost all from credit cards, now totals $957 billion, compared with $800 billion in 2004, according to the Federal Reserve. Argh!

Debt, Stress and Sleep Problems

I don't have to outline all the statistics that point to our heightened stress level. It's obvious to everyone living in the 21st century, unless you're in denial or have miraculously found the cure to conquering stress. But what the recent article and survey did not indicate is how much this stress is affecting people's sleep.

I have no doubts that today's intense stress levels are adversely affecting the quality and quantity of our sleep. Not only do we take our worries to bed with us, fueling insomnia, but we also delay going to bed as we tool around the Internet late at night paying bills or seeking support through others on the Web.

This sets us up for feeling more stressed out when sleep deprivation lowers our thresholds for enduring high stress levels. Our moods dim, our immune systems plummet, our body's hormonal clocks tick a little off, our hunger and satiety signals change, our ability to learn new things weakens, our concentration dwindles, our physical bodies miss out on a much-needed time-out to fully recover for the next day, and on and on.

Sleeping More Can Help You Cope

I could list a litany of problems associated with chronic sleep deprivation. I can also create an even longer list of benefits that come with getting a good night's rest.

And one of them would be this: being able to cope with and manage something as difficult and stressful as serious debt.

With a good night's rest, you feel energized, upbeat, refreshed, and focused. You can problem solve more easily and find ways to work through your debt so it doesn't become a pain in the neck, the back, your head, your heart, and soul. That said, let me suggest...

3 Ways to Conquer Debt through Sleep:

1. Set aside 15 minutes a day to focus on your debt and making plans to diminish it--but avoid doing this at night. Schedule it early in the day or first thing in the morning, and be done with it.
   


2. If your debt worries keep you up at night, start a Worry Journal. Have it by your bedside, and write in it as your stressful thoughts emerge. Then close the book and close your mind off those thoughts. If solutions or things to do in relation to those worries crop up as you write, record those.
   


3. Physical exercise is a great sleep promoter and stress reducer. If you find yourself avoiding exercise to "get more done" during the day, it's time to re-evaluate. Be sure to schedule in at least 30 minutes of physical exercise no matter what. It can be as simple as going for a brisk walk in the evening.

Don't let debt get your sleep. Becoming debt free will happen much more effortlessly if you have sweet dreams.

Related Topics:

• WebMD Video: Sleep and Stress
• 5 Life Changes that Prevent Stress

Technorati Tags: debt, stress, sleep, insomnia, anxiety

This post is cross-posted at Dr. Breus's blog, The Insomnia Blog.

Image: iStockPhoto.com

Attention Jet Setters Who Snore

Air travel just got more dangerous. A new report just came out indicating that flying strains the hearts of people with sleep apnea.

Obstructive sleep apnea is the most common form of the disorder; breathing becomes halted or very shallow for short bursts of time during sleep. Because of this, the levels of oxygen drop in the blood as not enough gets in through the nose or mouth. Imagine what this could mean for someone with heart or other vascular challenges.

Why Flying is More Dangerous for People with Apnea

It makes sense that the environment on a plane could exacerbate someone's sleep apnea. (It exacerbates a lot of things, like people's patience and flexibility.) Oxygen and pressure levels can change, and compounding the problem is the fact people who suffer from sleep apnea generally have higher metabolic demands during flights. In other words, their bodies--especially their hearts--have to work harder to stay fully oxygenated. It doesn't help that many people who suffer from sleep apnea have another problem: obesity. The two often go hand in hand.

How Will This Affect Air Travel?

Flying isn't as like it used to be. We now have to deal with smaller seats, packed planes, long waits, no food, and grumpy fellow passengers in general. It's not pleasant to sit next to a stranger who begins to snore and creep over into your space.

Snoring is a hallmark sign of obstructive sleep apnea. If the obesity rates continue to climb, will we have to set new standards for air travel? Wider seats? Extra oxygen tanks? Extra defibrillators? Cautionary signs in front of our seats that say "Attention Snorers or People with Apnea: Please Avoid Sleeping."?

I know this all sounds so extreme, but it's true that as a nation our obesity is raising the risk for all kinds of health challenges--many of which can be compounded on an airplane. If only people took to heart the fact that weight loss can cure so many problems, and in some cases, sleep apnea included.

But, if gas prices continue to soar, we could see an historic pullback in the number of people who can afford the luxury of flying. I've heard some speculate that flying will become an extravagance for the common person. The only jet setters left will be business types with corporate credit footing the bill. In any event, here's some advice:

5 Ways to Make Air Travel Safe(r) If You Snore

1. Eat well the morning of your flight and carry healthy snacks. Avoid fatty foods that can raise blood cholesterol and tax your system.


2. Get yourself a C-pillow to support your head so you can nap comfortably in your seat, this will also keep your head from bobbing and cutting off your air.


3. Avoid napping entirely if you cannot get into a comfortable position that prevents snoring. If you're seriously overweight, consider buying a business class ticket so you have more room.


4. Don't do anything stressful during the flight. Enjoy this time to relax, read something light, or have a conversation with the person next to you.


5. If the cabin pressure changes and you sense a higher heart rate, focus on taking a few deep belly breaths. Breathe in through your nose and out through your mouth. Let your belly expand outward as you inhale, and back to resting position as you exhale.

Have a nice flight.

Related Topics:

• Five Natural Remedies to Stop Snoring
• Sleep and Travel

Technorati Tags: apnea, air travel, sleep, sleep disorders, the sleep doctor
This post is cross-posted at Dr. Breus's blog, The Insomnia Blog.