When Work Stress and Poor Sleep Are a Deadly Mix

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A stressful job combined with impaired sleep are linked to a threefold higher risk of cardiovascular death in employees with high blood pressure.

Most of us know that work-related stress does not do a body good; nor does the lack of a good night's sleep. Both stress and poor slumber come with all kinds of health risks on their own, but for people with hypertension, the combination is even worse.

Just how bad is it? Work stress and impaired sleep are linked to a threefold higher risk of cardiovascular death in those with hypertension, according to new research published in the European Journal of Preventive Cardiology.

"Sleep should be a time for recreation, unwinding, and restoring energy levels. If you have stress at work, sleep helps you recover. Unfortunately poor sleep and job stress often go hand in hand, and when combined with hypertension the effect is even more toxic," says one of the authors, Karl-Heinz Ladwig, of the German Research Centre for Environmental Health and the Medical Faculty, Technical University of Munich.

The study is the first to look at how stress at work and impaired sleep contribute to death from cardiovascular disease in workers with hypertension.

The study looked at 1,959 workers aged 25 to 65 from the MONICA/KORA cohort study – all of the participants had hypertension, but without cardiovascular disease or diabetes. Compared to those with no work stress and good sleep, people with both risk factors had a three times greater likelihood of death from cardiovascular disease. People with work stress alone had a 1.6-fold higher risk while those with only poor sleep had a 1.8-times higher risk.

The definition of work stress is interesting: Jobs with high demand and low control. In other words, jobs in which there are high expectations, but the worker doesn't have the authority to make decisions. "If you have high demands but also high control, in other words you can make decisions, this may even be positive for health," said Ladwig. "But being entrapped in a pressured situation that you have no power to change is harmful."

Impaired sleep was defined as having a hard time falling asleep and/or staying asleep. "Maintaining sleep is the most common problem in people with stressful jobs," said Ladwig. "They wake up at 4 o'clock in the morning to go to the toilet and come back to bed ruminating about how to deal with work issues."

"These are insidious problems," he continued. "The risk is not having one tough day and no sleep. It is suffering from a stressful job and poor sleep over many years, which fade energy resources and may lead to an early grave."

"Each condition is a risk factor on its own and there is cross-talk among them, meaning each one increases risk of the other. Physical activity, eating healthily and relaxation strategies are important, as well as blood pressure lowering medication if appropriate," said Ladwig.

It's a tough situation. Most people don't have the luxury to just switch jobs; but stress adds to poor sleep, poor sleep adds to stress, and they all add to increased risk of cardiovascular death in hypertensive workers. It would be great to see employers implementing more stress management at the workplace, and workers would be well-served by adopting their own stress-reducing and sleep-promoting activities. Four-day work weeks and nature breaks, anyone?