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Is there any scientific evidence supporting the hypothesis that physical exercise following lack of sleep increases the risk of sudden cardiac death (SCD)?

The only relevant research I could find is: Reddy PR, Reinier K, Singh T, et al. Physical activity as a trigger of sudden cardiac arrest: The Oregon Sudden Unexpected Death Study. International journal of cardiology 2009;131(3):345-349. doi:10.1016/j.ijcard.2007.10.024. However, it only points out that 5% of the SCD cases in the sample took place during vigorous physical activity, which does not directly answer my question.

I am not a biology professional, so please pardon me for any misunderstanding, and, when possible and reasonable, please avoid using too many biological jargons in the answer.

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    $\begingroup$ The closest I found: Acute sleep deprivation is associated with increased QT dispersion in healthy young adults. A surrogate endpoint, but a plausible one given that long QT is one of the more common causes of SCD during exercise. Research in the general population using the endpoint of SCD itself is nearly always retrospective and plagued by reporting bias. $\endgroup$
    – Susan
    Dec 9 '14 at 9:04
  • $\begingroup$ I am probably not the best person to answer this, but I know of someone who had heart issues while training for a marathon while working long hours as a white collar worker. He also had trouble falling asleep a lot, even if he was feeling tired. This was probably because he was so pumped up at the time. He told me that sleep exercises helped him though.. $\endgroup$
    – draisabin
    Oct 30 '17 at 8:08
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Sleep is an important aspect of our life. Sleep disorders are acute due to their effects in physiological and mental health of a person.Sleep occupies nearly 30% of our daily life and people were gradually decreasing the sleep time in order to adjust their busy schedule. According to the United States National Sleep Foundation, adults need to sleep 7-9 hours each night. The decrease in sleep time contribute mostly towards cardiovascular disease, including hypertension, coronary artery disease(CAD),risk of arrhythmia, stroke etc.

The circadian and dirurnal rhythms influence the neural circulatory control causing the changes in heart rate, vascular tone and blood pressure. The REM(Rapid Eye Movement)sleep and nonREM sleep affects the cardiovascular system. Researchers found it important that normal sleep is a complex and dynamic process with profound effects on cardiovascular homeostasis. Insufficient sleep is a stress stimulator that acts through the sympathetic nervous system elicit changes in blood pressure, heart rate and barroreflex setpoint.

Sleep deprivation is a state of having less or no sleep which is a major reason for cardiovascular diseases.Which may cause

Inflammation

Cardiovascular disease is mainly driven by atherothrombosis, which is an inflammatory process. Increased levels of C-reactive protein(CRP) and interleukin-6(IL6) have been implicated as the predictors of cardiovascular disease risk.Both CRP and IL6 have been found elevated in both totally and partially sleep-deprived subjects.Inflammatory cells such as monocytes and neutrophils were also found to be elevated during acute sleep deprivation, supporting that sleep deprivation is an inflammatory process.

Endothelial Dysfunction

Endothelial Dysfunction has been reported after a combination of sleep deprivation and stress, also increased heart rate, blood pressure are reported in sleep deprived subjects may result in Endothelial Dysfunction.

Hypertension and Stress

Hyper tension and stress hormones are released by the body when lack of sleep occurs, this results in elevated bloop pressure and may lead to CAD.

CardioArtery Disease

The American Cancer Society , the Almeda County study and Partinen also showed an increased risk of CAD in subjects who reported sleeping 4-6 hours a day.

Diabetes Mellitus(DM)

Diabetes Mellitus is a major risk factor for CAD and it has been underlined from several studies across past decades that sleeplessness can result in DM.


A sudden cardiac death is highly probable for a person who follows increased physical exercise and decreased sleep durations. For a sleep deprived person the risk of cardiac diseases are so high, then for some one who spend lot of time exercising can cause chronic cardiac problems. Physical exercise and over training can cause more stress hormones and increased heart rates, these factors along with prolonged sleep deprivation can cause serious cardiac diseases or even sudden cardiac death.


Levels of cortisol (the "stress" hormone) are elevated for long periods of time. The body spends more time in a catabolic state than an anabolic state (perhaps as a result of elevated cortisol levels). Excessive strain to the nervous system during training. http://en.wikipedia.org/wiki/Overtraining

References

Critical Care Nursing: Synergy for Optimal Outcomes - Roberta Kaplow

Sleep Deprivation and Disease: Effects on the Body, Brain and Behavior - Matt T. Bianchi

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  • $\begingroup$ You've brought in some interesting theoretical reasons why one might wonder about an association between sleep deprivation and SCD, but to my knowledge this research has been either 1) in chronic sleep deprivation (CAD, DM, HTN) or 2) in acute sleep deprivation using surrogate endpoints (cytokines, HTN - though the latter is certainly a good surrogate). To conclude that A sudden cardiac death is highly probable... for the OPs scenario of exercise after acute sleep deprivation seems like a leap. $\endgroup$
    – Susan
    Dec 9 '14 at 8:11
  • $\begingroup$ @Susan:I have edited to "prolonged sleep deprivation", I personally know cases of SCD due to heavy exercise and lack of sleep. I have claimed that "highly probable" not always possible. So its really a highly risk situation for a person following these appetites. Thank you for your valuable suggestions. $\endgroup$ Dec 9 '14 at 8:47

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