The Dangers of Sleep Deprivation

A few months 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 let alone corporate Asia. However, it was even more disastrous for runners amongst us. Since Ranjan was an avid marathoner  ( in Feb 09, he ran the Chennai Marathon) the question arises as to why an exceptionally active, athletic person succumbs to heart attack at 42 years of age.

Was it the stress?

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.

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 ).

I have outlined the key points below in the hope it will save some lives.

· Short sleep duration ( <5 or 5-6 hours ) increased risk for high BP by 350% to 500% compared to those who slept longer than 6 hours per night. Paper published in 2009. As you know, high BP kills.

· Young people ( 25-49 years of age ) are twice as likely to get high BP if they sleep less. Paper published in 2006.

· Individuals who slept less than 5 hours a night had a 3-fold increased risk of heart attacks. Paper published in 1999.

· 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!!

· 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.

· 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.

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. This part of sleep is when HGH or Human Growth Hormone is naturally generated. If you are not asleep, what happens is that you generate cortisol which is a stress hormone that has the long term effects of accelerating ageing and leading the production of toxic substances like IL-6, TNF-alpha and cRP.

In Chinese Medicine we have the concept of chi and its movement in different meridians at different times. The Liver Meridian is particularly active from 1.00 am to 3.00am. If you are asleep, your Liver Meridian can properly detoxify as well as your mesenchymal matrix. If you are not, then this function is perverted and your natural cellular detoxification mechanisms start shutting down. This prepares your body for the development of severe and chronic diseases.

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 ).

Unfortunately, Ranjan Das is not alone when it comes to missing sleep. Many of us are doing exactly the same, perhaps out of ignorance.

Two years ago, I developed a devastating infection called rheumatic fever and experienced heart failure (heart function dropped to 30%). This was a period in my life when I was eating well, exercising well (too well- averaging almost 12 hours in aerobics, weights and Martial arts) and sleeping 5 hours a day. There was one month when I worked right through non-stop and the infection struck. My blood profile was perfect except for elevated  CRP, Creatinine Kinase and the infection marker. All the other markers of heart disease like cholesteol, triglycerides, glucose, sodium and potassium were perfect. It has taken me almost two years to get back to normal.

Please forward this blog 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 blog, I would be the happiest person on earth.

Be well

Dr Sundardas