Winter 2011
ASK THE EXPERT
ASK THE EXPERTS
Depression and Your Heart


Charles Morgan, MD
Q: I’ve heard that people who survive a heart attack or who have heart surgery can develop depression. True?

Chairman of Psychiatry Charles Morgan, MD, responds:

A: Life can be very different for anyone who survives a life-ordeath cardiac event or who undergoes major heart surgery due to heart disease. Following the event, patients often expect to have to make some serious lifestyle changes in what they eat or how much they exercise. Others quit smoking or work on reducing stress. What many don’t expect is depression. For some, the depression will go away on its own in a few months. However, many people suffer from depression much longer than necessary and live each day waiting to feel like themselves again.

Research indicates an association between depression and heart disease, but the exact reason for the relationship remains inconclusive. Here are some other facts about the cardiac-depression connection:

  • About 1 in 3 adults in the United States who have survived a heart attack experience depression.
  • Many people who have been hospitalized for unstable angina, angioplasty, bypass surgery and valve surgery also experience depression.
  • Depression is slightly higher in those with congestive heart failure.

Depression can get in the way of cardiac recovery. Depression can also bring on new health concerns, so it’s important for all adults who have survived a cardiac event to be evaluated by their physicians. Survivors can benefit greatly from early recognition and treatment, because treatment can improve quality of life and well-being.

Sleep and Your Heart


Armand Wolff, MD
Q: I typically don’t sleep well. Can lack of sleep hurt my heart?

Medical Director of the Center for Sleep Medicine Armand Wolff, MD, FCCP, FAASM, responds:

A: The more we learn about sleep, the more we understand how truly vital it is to maintaining our overall health. In addition to affecting our memory, our moods and our energy levels, research has shown that too little sleep, interrupted sleep and sleep disorders, such as sleep apnea, also take a toll on the heart.

People who have sleep apnea stop breathing for up to a minute during sleep. As they struggle to breathe, the brain reacts by waking the person up enough to reopen the windpipe. This cycle can repeat hundreds of times a night, resulting in interrupted sleep, low oxygen levels in the body and, as emerging research indicates, a greater risk for heart disease. In fact, sleep apnea has been linked to high blood pressure, irregular heartbeats and an increased risk of heart attacks and stroke.

Research has also shown a link between lack of sleep and elevated blood pressure. Blood pressure levels should naturally drop when we sleep. It’s a normal response. People with sleep apnea or who aren’t sleeping enough do not experience that nightly drop in blood pressure. Over time, a sustained blood pressure level may be harmful to the heart.

A sleep study is the first step in identifying a sleep disorder and, sometimes, a heart condition. A sleep study tracks a patient’s breathing, brain waves and heartbeat for an entire night. Occasionally, the heart data shows that in addition to a sleep disorder, a patient also has atrial fibrillation or another cardiac arrhythmia.

Getting a good night’s sleep on a regular basis is very beneficial to our overall health, and it sounds like it’s been awhile since you’ve slept well. Please talk to your doctor about ways you can improve your sleep—and possibly protect your heart.

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