The Sleep-Cardiovascular Risk Relationship Highlighted at AHA2018

On Saturday at the America Heart Association Scientific Sessions we attended a morning session titled ‘Reducing Cardiometabolic Risk by Improving Sleep’, a topic that is near and dear to my heart.

The four talks ranged in scope from how sleep can improve cardiovascular (CV) risk, to how much sleep one needs, to the role of the circadian system in CV health & disease. This area of study is closely related to my doctoral thesis work, which focused on the molecular mechanisms of the circadian clock- literally how that clock functions on a sub-cellular level.


While the circadian system is not well known by consumers (and even physicians for that matter), it has a role in nearly every major organ system and disease… cancer, neurodegenerative diseases like Alzheimer’s, infertility, and yes obesity, metabolic, and CV disease. It’s very exciting to see docs now interested in the role it plays, learning how its disruption influences health and disease, and asking how they can start to implement measures to improve function of the circadian system, lower risk of disease, and improve the health of their patients.

Data presented at this year’s AHA conference included a review of direct and indirect effects of sleep disruption on CV risk & outcomes. There is a clear relationship between both good sleep and lower disease risk/improved CV outcomes and between poor sleep and higher disease risk/worse CV outcomes.

The session speakers highlighted the direct and indirect negative effects that sleep disruption can have on CV disease risk (development of diabetes, atherosclerosis, etc), and cardiometabolic outcomes (changes in blood glucose, stroke, heart attack, etc). They also called attention to the benefit good quality sleep can have on these same parameters, luckily it’s not just a one sided situation- good sleep can dramatically reduce risk and improve outcomes!

However, sleep is not something one can fix with a snap of a finger, or a prescription pad. The first step is assessment; are you getting enough sleep? Are you able to fall asleep without tossing and turning for a long period of time? Do you sleep through the night? Do you feel rested when you wake up?

The next step is education; bright light, even a cell phone screen or TV within 1-2 hours of bedtime is enough light to disrupt the natural process your brain uses to transition to sleep. Move the TV out of the bedroom, turn off the cell phone, and make the bedroom environment conducive to sleep.

The last step is execution; don’t burn the candle at both ends, sleep is an important part of good health so proactively make time for it.


Often what we see on our program is after about 7-10 days clients report sleeping ‘better’… for some that means falling asleep more readily, waking up less often, and/or feeling rested and refreshed the next morning. Overall that improvement is important, no matter what aspect it is from.

Dr. Dembrowski and I understand that obesity, metabolic and CV diseases are extremely complex, and as a result, there is no single target or thing that will prove effective in combating them. Packaged foods, counting points, a pill prescribed for high blood pressure or high cholesterol, no carbs… these things are not going to address the problem and are not going to be effective in improving your health over the long term. They can provide short term changes, transient effects on the scale, they can treat the symptoms by reducing your blood sugar or blood pressure but they do not change the disease process itself… period, end of discussion.

20Lighter flagship programs were designed to be highly integrated- to incorporate as many different complimentary strategies to disrupt the mechanisms promoting disease, because that is how you have a real long term positive impact on health you go after what is causing it.

I could talk for hours about different aspects of the 20Lighter Program—our meal plan design, the natural strategies we use to break the cycle of inflammation throughout the body, how our programs are designed to re-establish robust circadian signaling and why that is so important, the role education of healthy sleep habits plays, or about the importance of reducing more than just body weight. We are fundamentally different because our programs are not predicated on a single ‘thing.’ All the aspects I just mentioned are equally important to the overall long term success of 20Lighter clients.

Think of it this way, you have driven your car for years over very poorly maintained roads and as a result the frame is bent, the suspension is shot, gas mileage is poor, and the tires wear unevenly. If you use a better grade of gas or get new tires, will it fix the problem?


Nope—It may temporarily improve the symptoms (worn out tires and bad gas mileage) but it will not fix the underlying issues that cause the car to have problems.

What makes 20Lighter different and why our program so effective for so many people is that we take a shotgun approach as we go after those causative issues, and we do it in a way that is not complicated from a client perspective. Our programs require commitment and work, but they are straightforward and they are relatively short.

Obesity, metabolic, and CV disease are complex health issues, the reasons why and how 20Lighter programs are painstakingly designed are equally complicated, but the program itself is not complicated and stunningly effective.