Sleep Duration and Coronary Heart Disease in Women

James Michael Howard jmhoward at
Thu Jan 30 11:38:39 EST 2003

Sleep Duration (Short Sleep and Longer Sleep) and Coronary Heart Disease in

A Possible Explanation

James Michael Howard
Fayetteville, Arkansas, U.S.A.

Ayas, et al., reported: "Short and long self-reported sleep durations are
independently associated with a modestly increased risk of coronary events."  In
"A Prospective Study of Sleep Duration and Coronary Heart Disease in Women,"
Archives of Internal Medicine 2003; 163: 205-209  ( )

It is my hypothesis that melatonin and DHEA act in what I call the "melatonin -
DHEA cycle," and determine the sleep - wake cycle. I think this cycle may be
necessary for proper growth and development and maintenance in adults.
Melatonin and DHEA actively control the release of the each other. I suggest the
positive effect of this cycle is production of DHEA. Now, if the cycle is not
acting properly, as a whole, that is, if melatonin is reduced, DHEA will be
reduced. Reduced melatonin would result in reduced sleep. Hence, the short sleep
period would coincide with reduced DHEA and adverse effects on the heart. Now,
if the cycle is disturbed in underproduction of DHEA, but normal production of
melatonin, then one would see the negative effects of reduced DHEA on the heart
but increased sleep duration due to abnormal effects of even normal amounts of
melatonin on sleep. Hence, extended sleep would also be connected to increased
coronary events. (This cycle is explained in my explanation of sleep at: .)

Reduced melatonin has been connected with coronary heart disease: Wien Klin
Wochenschr 1997; 109: 747-9 and Lancet 1995; 345: 1408. Reduced DHEA has been
connected with coronary heart disease: Heart 1998; 80: 334-7 and Circulation
1994; 89: 89-93.

I suggest the findings of Ayas, et al., may be explained by an abnormal
"melatonin - DHEA cycle."

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