Is Insomnia Deadly?

Can a lack of sleep raise your risk of death? People who suffer from persistent, or chronic, insomnia—which affects about 10 percent of U.S. adults—have a 58% higher risk of death than those who don’t, according to a recent study from the University of Arizona in Tucson.

The researchers, led by Sairam Parthasarathy, MD, associate professor of medicine at the University of Arizona College of Medicine, looked at the data on more than 1,400 participants in the Tucson Epidemiological Study of Airway Obstructive Disease (TESAOD). The study participants enrolled in 1972 and were followed until 1996, though deaths in the group were monitored through 2011.

Participants were categorized as having persistent insomnia, intermittent insomnia, or no insomnia. Persistent or chronic insomnia is generally defined as insomnia lasting for at least three months, while intermittent insomnia lasts for less than that, according to Richard Castriotta, MD, director of pulmonary and sleep medicine at The University of Texas Health Science Center at Houston (UTHealth) and medical director of the Sleep Disorders Center at Memorial Hermann-Texas Medical Center.

The results confirmed that persistent insomnia can be hazardous to your health: 46 (close to 36%) of the 128 study participants with persistent insomnia died during the follow up, whereas only 23% of people with intermittent, and 20% of those who’d never had insomnia, died during that time.

Why Is Insomnia so Dangerous?

Why is persistent (though not intermittent) insomnia so dangerous? "Persistent insomnia taxes the cardiovascular [heart and blood vessels] system over longer periods of time," says Shelby Harris, Psy.D., director of Behavioral Sleep Medicine at the Sleep-Wake Disorders Center at Montefiore Medical Center in New York City. "This causes the higher risk of cardiovascular issues that were seen in the persistent insomnia group."

Insomnia, especially when it's chronic, has a huge impact on the body, says Lisa Liberatore, MD, FACS, sleep specialist and otolaryngologist (ENT) at Lenox Hill Hospital in New York City. "This is because of the elevated levels of the stress hormone cortisol in these individuals," she says. "This leads to elevation in blood pressure and elevated blood sugar levels." And, she adds, elevated levels of the stress hormone can result in an increase in abdominal [belly] fat, which places additional stress on the cardiovascular system.

Chronic insomnia is routinely linked to numerous health problems, including hypertension (high blood pressure), obesity, depression, diabetes, heart attack, and stroke, Harris says. "It is a serious problem that needs to be addressed to help reduce the risk of morbidity [sickness] and mortality," she adds.

What You Can Do

If you suffer from persistent insomnia, your doctor will look for any problems that could be affecting your sleep, says Marc Leavey, MD, of Mercy Medical Center in Baltimore. Examples of these problems include sleep apnea (in which patients breathe shallowly or experience pauses in breathing during sleep), an over-active or an under-functioning thyroid gland, or iron deficiency, which could cause both restless legs syndrome and periodic limb movements during sleep, says Castriotta. Adds Leavey: "Overlooked issues such as menopause and obesity can influence sleep as well, as can uncommon conditions like narcolepsy [in which a patient suddenly falls asleep]."

"After these are ruled out," Leavey concludes, "you will have a discussion of sleep hygiene," that is, ways to ensure you’re maximizing your chances of a good night’s rest.

7 Habits for Healthy Sleep

To get a good night’s sleep, try these tips:

  1. Eat dinner at least three hours before bedtime. "This allows enough time for dinner to digest before you go to sleep," Liberatore says.
  2. If you have insomnia, avoid caffeine and alcoholic beverages. "And that means not just coffee and black tea, but also green tea, some soft drinks, and chocolate, too," says Castriotta.
  3. Exercise regularly, but avoid doing heavy exercise right before bedtime. "Exercising at night can keep you awake as it gets the wrong hormones going," Castriotta points out.
  4. Set the tone for good, restful sleep by limiting excessive light, decluttering, and turning off electronic devices in the bedroom. "The hormone melatonin, which is important for sleep, requires an absence of light in order for our bodies to secrete it from the pineal gland," Liberatore explains.
  5. Make sleep a priority. "Wind down for an hour before bed," Harris says. "This includes turning off anything with a screen and finding 'old school' ways to relax. Listening to music, reading a book or magazine, or doing something quiet, calm, and relaxing in dim light are good."
  6. Keep the same bedtime and wakeup times every day of the week, including weekends.
  7. Use a gentle alarm or a wake light to waken you in the morning, and get out of bed right away. "Don’t lounge in bed," Leavey says, "and limit naps during the day."

Marc Leavey, MD, reviewed this article.

Sources

Castriotta, Richard, MD. Phone interview on March 24, 2015.

Harris, Shelby, PsyD. Email interview on March 24, 2015.

Leavey, Marc, MD. Email interview on March 27, 2014.

Liberatore, Lisa, MD, FACS. Email interview on March 24, 2015.

Parthasarathy, S., M.M. Vasquez, M. Halonen, R. Bootzin, S.F. Quan, F.D. Martinez, S.G. Guerra. "Persistent Insomnia Is Associated with Mortality Risk." American Journal of Medicine 128, 3 (2015): 268-275.

Ohayon, M.M. "Epidemiology of Insomnia: What we Know and What we Still Need to Learn." Sleep Medicine Reviews 6, 2 (2002): 97-111. DOI: http://dx.doi.org/10.1053/smrv.2002.0186

"UA Researchers Find Connection Between Persistent Insomnia, Inflammation and Mortality." University of Arizona Health Sciences Center Office of Public Affairs. Page accessed April 13, 2015.

"Persistent Insomnia Linked to Higher Risk of Death, Study Finds." Medical News Today. Page accessed April 13, 2015.