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  1. #1
    oneews is offline Amateur
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    Lack of Sleep and Cardiac Problems

    What killed Ranjan Das and Lessons for Corporate India
    A month ago, many of us heard about the sad demise of Ranjan Das from Bandra, Mumbai. Ranjan, just 42 years of age, was the CEO of SAP-Indian Subcontinent, the youngest CEO of an MNC in India. He was very active in sports, was a fitness freak and a marathon runner. It was common to see him run on Bandra's Carter Road. Just after Diwali, on 21st Oct, he returned home from his gym after a workout, collapsed with a massive heart attack and died. He is survived by his wife and two very young kids.

    It was certainly a wake-up call for corporate India. However, it was even more disastrous for runners amongst us. Since Ranjan was an avid marathoner (in Feb 09, he ran Chennai Marathon at the same time some of us were running Pondicherry Marathon 180 km away), the question came as to why an exceptionally active, athletic person succumb to heart attack at 42 years of age.
    Was it the stress?
    A couple of you called me asking about the reasons. While Ranjan had mentioned that he faced a lot of stress, that is a common element in most of our lives. We used to think that by being fit, one can conquer the bad effects of stress. So I doubted if the cause was stress.
    The Real Reason
    However, everyone missed out a small line in the reports that Ranjan used to make do with 4-5 hours of sleep. This is an earlier interview of Ranjan on NDTV in the program 'Boss' Day Out':
    Boss' Day Out: Ranjan Das of SAP India
    Here he himself admits that he would love to get more sleep (and that he was not proud of his ability to manage without sleep, contrary to what others extolled).

    The Evidence
    Last week, I was working with a well-known cardiologist on the subject of ‘Heart Disease caused by Lack of Sleep’. While I cannot share the video nor the slides because of confidentiality reasons, I have distilled the key points below in the hope it will save some of our lives.
    Some Excerpts:
    &#183; Short sleep duration (<5 or 5-6 hours) increased risk for high BP by 350&#37; to 500% compared to those who slept longer than 6 hours per night. Paper published in 2009.
    As you know, high BP kills.
    &#183; Young people (25-49 years of age) are twice as likely to get high BP if they sleep less. Paper published in 2006.
    &#183; Individuals who slept less than 5 hours a night had a 3-fold increased risk of heart attacks. Paper published in 1999.
    &#183; Complete and partial lack of sleep increased the blood concentrations of High sensitivity C-Reactive Protein (hs-cRP), the strongest predictor of heart attacks. Even after getting adequate sleep later, the levels stayed high!!
    &#183; Just one night of sleep loss increases very toxic substances in body such as Interleukin-6 (IL-6), Tumour Necrosis Factor-Alpha (TNF-alpha) and C-reactive protein (cRP). They increase risks of many medical conditions, including cancer, arthritis and heart disease. Paper published in 2004.
    &#183; Sleeping for <=5 hours per night leads to 39% increase in heart disease. Sleeping for <=6 hours per night leads to 18% increase in heart disease. Paper published in 2006.
    Ideal Sleep
    For lack of space, I cannot explain here the ideal sleep architecture. But in brief, sleep is composed of two stages: REM (Rapid Eye Movement) and non-REM. The former helps in mental consolidation while the latter helps in physical repair and rebuilding. During the night, you alternate between REM and non-REM stages 4-5 times.
    The earlier part of sleep is mostly non-REM. During that period, your pituitary gland releases growth hormones that repair your body. The latter part of sleep is more and more REM type.
    For you to be mentally alert during the day, the latter part of sleep is more important. No wonder when you wake up with an alarm clock after 5-6 hours of sleep, you are mentally irritable throughout the day (lack of REM sleep). And if you have slept for less than 5 hours, your body is in a complete physical mess (lack of non-REM sleep), you are tired throughout the day, moving like a zombie and your immunity is way down (I’ve been there, done that L)
    Finally, as long-distance runners, you need an hour of extra sleep to repair the running related damage.
    If you want to know if you are getting adequate sleep, take Epworth Sleepiness Test below.


    Interpretation: Score of 0-9 is considered normal while 10 and above abnormal. Many a times, I have clocked 21 out the maximum possible 24, the only saving grace being the last situation, since I don’t like to drive (maybe, I should ask my driver to answer that line J)

    In conclusion:

    Barring stress control, Ranjan Das did everything right: eating proper food, exercising (marathoning!), maintaining proper weight. But he missed getting proper and adequate sleep, minimum 7 hours. In my opinion, that killed him.
    If you are not getting enough sleep (7 hours), you are playing with fire, even if you have low stress.

    I always took pride in my ability to work 50 hours at a stretch whenever the situation warranted. But I was so spooked after seeing the scientific evidence last week that since Saturday night, I ensure I do not even set the alarm clock under 7 hours. Now, that is a nice excuse to get some more sleep. J

    Unfortunately, Ranjan Das is not alone when it comes to missing sleep. Many of us are doing exactly the same, perhaps out of ignorance. Please forward this mail/article to as many of your colleagues/friends as possible, especially those who might be short-changing their sleep. If we can save even one young life because of this email, I would be the happiest person on earth.
    Madhur Kotharay
    madhur@alumni.princeton.edu
    98200-30778

    ps: Incidentally, just as human beings need 7 hours of sleep, you should know that cats need 15 hours of sleep and horses need 3 hours of it. So are you planning to be a cool cat or a dumb horse? J
    Last edited by oneews; 11-11-2009 at 09:31 PM. Reason: Add source: kalina_friends@yahoogroups.com
    Anantha Bala
    Mail: zzz9@in.com
  2. #2
    Ramacchandran is offline Senior Member
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    But dear Bala, people in this generation prefer to work in Night shifts conitiniouly and as per the IT sector, the boy who locked himself with a project returns home after 3 days hard work. The salary is more no doubt, but we are to loose something to gain few comforts.
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  4. #3
    kunjuppu is offline Veteran
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    one,

    i am 100&#37; in agreement with this article.

    i need minimum 8 hours of sleep a night and a total of about 60 hours a week. where i cut short in any night, my body demands that it be made up in a few days.

    the long term effect of sleep deprivance can be fatal. i agree. sleep is the time for the body to repair itself from the ravages of modern living.

    bringing over daytime tension to the night, affects not only the abilty to sleep, but also if achieved, its quality as well. i do not know how, but we cannot simply afford to carry over our work tensions to home to sleep time.

    also, another warning for fitness buffs.

    be very careful when you substitute proteins for food. i was told of potential kidney damage.

    also, some advocate to drink minimum of 8 litres of water per day. it may result in a clean system, but i was told it kills your kidneys.

    so, i would recommend caution before going to extremes.

    i also believe tension causes stress, and stress kills.
    Last edited by kunjuppu; 11-11-2009 at 10:33 PM.
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  6. #4
    pannvalan's Avatar
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    This is really an eye opener for all.

    For the sake of extra bucks, risking one's life is bad and totally uncalled for.

    I too need a sleep for 8 to 9 hours a day.

    Doctors say, 'if you cannot afford to sleep long hours, at least lie down, close your eyes and be relaxed. You may listen to some 'soft and sweet music' by keeping the volume very low - just audible to you only.

    Never brood on the mistakes committed by you or the injustice meted out to you (in your assessment) or the problems that lie ahead. Keep this space exclusively for yourself".


    Sleep, Hunger and Motion at right time and at the right level indicate one's physical health that causes no worry to anyone.
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  8. #5
    KRS
    KRS is offline Super Moderator
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    I have always heard that 'hard work never killed anyone'. I know very high energy people who can not sleep beyond five hours a night. A lot of them are my contemporaries, in their sixties and seventies and doing well physically.

    I suspect the lack of sleep for the person mentioned here is probably due to his physiology interacting badly with his personality - he seems to be an 'A' type personality. I am sure his body was giving out warning signs, that he probably dismissed or missed.

    I do not think that there is a prescribed amount of sleep necessary for everyone. It can vary from as little as 4 hours to all the way to 9 hours, depending on one's physiology. I think the factor that kills is tension that causes hyper tension and if your genes are susceptible to heart attack, then you are at very high risk.

    Learn to listen to your body's cries for help, as it always tries to warn you beforehand.

    Regards,
    KRS
    Last edited by KRS; 12-11-2009 at 12:05 AM.
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  10. #6
    oneews is offline Amateur
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    @KRS.. In order to assess whether a person is having adequate sleep the author of this article has recommended Epworth Test.
    Anantha Bala
    Mail: zzz9@in.com
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  12. #7
    KRS
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    Dear oneews Ji,

    Yes, I am not contradicting the author's recommendations or conclusions. Mine is supplemental. I think that one knows when one is sleep deprived if one is attuned to one's body and the test will confirm that.

    Regards,
    KRS
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  14. #8
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    pvraman is offline Active Member
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    Thanks for the information. This will help me.
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  16. #9
    renuka's Avatar
    renuka is offline Veteran
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    Just to share with everyone.Lack of sleep is a serious problem these days.
    In malaysia where i stay many of my patients are also temple priest(brahmanas), who are displaying early symptoms of cardivascular disease, diabetes and high blood pressure.Invariably many of them have abdominal obesity and high body fat percentage( not neccasarily obese but a high fat to muscle ratio).
    Many of them do not get enough sleep may be about 4-5 hours or even less because of working conditions in Malaysia.
    None of them ever exercise, not even Yoga because of severe time constrain.
    I always advise them to have time off to exercise and have more sleep but many say
    its not possible.
    I do not know how the condition is in India.
    Diet also plays a very important role in determining Cardivascular Health.
    Being vegetarian is not enough. Unknowingly many vegetarians consume a high carbhohydrate,low protein diet which accelerates the Triad of cardiovascular disease, diabetes and hypertension i had mentioned earlier.
    Each meal should have a good portion of protein eg of protein sources: curds, sprouted mung beans,garbenzo beans(popular in india), soya milk, soya beans and paneer, a good power pack protein dish is mashed garbenzo beans with curds.
    Protein increases the body metabolic rate which prevents fat deposition esp in the midsection.

    Kindly read the following.

    How are sleep and heart disease related?


    by Charles W. Bryant
    Cite This!
    Close

    Please copy/paste the following text to properly cite this HowStuffWorks article:

    Bryant, Charles W. "How are sleep and heart disease related?." 03 September 2008. HowStuffWorks.com. <http://health.howstuffworks.com/sleep-and-heart-disease.htm> 11 November 2009.


    Inside this Article

    1. How are sleep and heart disease related?
    2. Effects of Sleep Deprivation on the Heart
    1. Lots More Information
    2. See all Sleep articles

    Health Videos





    Effects of Sleep Deprivation on the Heart

    There's an old joke among doctors that the function of sleep is to cure sleepiness. Despite an abundance of research, we still aren't sure exactly why we sleep. But we know we need to. Recent studies indicate that too much or too little sleep can be a factor in developing heart disease, just like smoking and packing on the pounds.







    A 10-year study performed by Harvard University tracked the sleep habits and health of more than 70,000 women between the ages of 45 and 65 that had no previous history of heart disease. In the end, 934 of these women suffered from coronary heart disease and 271 died from it. The researchers accounted for factors like age, weight and whether they smoked, then looked at the subjects' sleep patterns. Five percent of the women slept less than five hours per night. Those women were nearly 40 percent more likely to suffer from heart disease than women who slept an average of eight hours. Women who slept more than nine hours per night were 37 percent more likely to have heart trouble.
    Previous studies have shown similar results for men. Short-term sleep deprivation is known to raise blood pressure and stress hormones, lower glucose tolerance and even lead to irregular heartbeats. All of these factors are precursors to coronary disease. Chronic sleep deprivation promotes weight gain and diabetes, both of which can send you to the emergency room grabbing your chest. Going without enough sleep also affects the functioning of the lining inside the blood vessels and can cause some low-grade inflammation that could lead to heart disease.
    Sleep apnea is another problem. This is a condition that makes your airway temporarily collapse when you sleep, forcing you to wake up and resume breathing. This makes for fitful sleep at best. Research has shown that people with sleep apnea also show marked increases in their blood pressure over the years. They also have a higher level of sympathetic nervous system (SNS) action. The SNS controls the heart rate and the constriction of the blood vessels. If you don't have sleep apnea, shortly after you fall asleep, your blood pressure and SNS activity will slowly fall. This can't happen when you're waking up at regular intervals to resume breathing.
    If you think you're in the clear because you're a young whipper-snapper, think again. Teens that sleep less than 6.5 hours per night are more than twice as likely to get high blood pressure [source: AHA]. When you consider that teens average roughly seven hours of sleep when they require nine, it's clear that kids need to put down that Guitar Hero axe, shut off the iPhone and catch some Zs.
    Now for the good news. If you want to eliminate this factor from whether you develop heart disease, all you need to do is go beddy-bye for eight hours. There are other factors, like what you eat and how much you exercise, but this one is taken care of by doing something most people love to do -- sleep. Doctors even believe that 30-minute naps a few times a week can improve your health, and many forward-thinking companies are outfitting their buildings with nap rooms.
    If you have trouble sleeping, make your bedroom a haven for slumber. Paint your walls in cool blues. Ditch the TV and the laptop. Try to sleep eight hours each night -- you're doing your heart a big favor
    Last edited by renuka; 12-11-2009 at 07:44 AM.
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  18. #10
    pannvalan's Avatar
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    Thanks for the medical advice, Doctor.

    I wish to add these.

    Stress in modern world, especially in urban settings, is said to be the cause for highest number of deaths (by cardiac arrest and suicides), next only to accidents.

    Coping stress is not everybody's cup of tea. Even well educated persons find it hard to find right kind of solutions. We must remember the adage "Prevention is better than cure". The Tamil equivalent is "Varum mun kaappom".

    Youth of today over-estimate their physical strength and tolerance/immunity level.

    I have these specific suggestions.

    1. Apart from regulating food habits, taking rest for 5 minutes, after every 1 hour of
    strenuous work will have salutary effects.

    2. Without sitting at one place, in one posture continuously for several hours, learn
    to walk within the office every 30 minutes.

    3. Instead of depending on menial staff, for bringing some stationery or water or a
    file, why don't you go and get it yourself. (It is a good exercise you would be
    doing, without your being aware of it).

    4. Appropriate illumination, preferably natural lighting, good ventilation (again
    preferably natural ventilation), right seating arrangement (ergonomically designed,
    varying with different persons, their nature of work etc.) and hygienic environment
    inside the office etc. are very essential. By hygienic environment I mean
    cleanliness, dust-free, noise-free environment, safe drinking water and clean
    toilets.

    5. Don't wear your official hat always. Once in a while, free yourself from office work
    and converse with your colleagues, not just peers, to share some personal
    thoughts and experiences.

    6. Laugh aloud, because humour is one of the best medicines for stress.

    7. Change your routine, off and on. For example, the mode of transport, helping the
    kids in their studies, dropping them at their school/college, helping your wife in her
    daily chores etc.

    8. Take your entire family for an outing, at least once a month. (Avoid crowded
    places like cinema theatres).

    9. Visit some far off place, suiting your budget, at least once a year, with your
    family.

    10. Most important:

    Be honest and simple. You need not fear anyone.

    11. Last but the least, if something happens despite all these precautions, never
    panic. It's just another phase of (this) life. That's all.
    Last edited by pannvalan; 12-11-2009 at 08:33 AM. Reason: correction
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