In reality, a heart attack victim could easily be a woman, and the scene may not be that dramatic. It occurs when the blood flow that brings oxygen to the heart muscle is severely reduced or cut off completely. This happens because the arteries that supply the heart with blood can slowly narrow from a buildup of fat, cholesterol and other substances plaque. Watch an animation of a heart attack. Many women think the signs of a heart attack are unmistakable — the image of the elephant comes to mind — but in fact they can be subtler and sometimes confusing.
Some women experiencing a heart attack describe upper back pressure that feels like squeezing or a rope being tied around them, Goldberg said. Dizziness, lightheadedness or actually fainting are other symptoms to look for. Heart Attack. About Heart Attacks.
Warning Signs of a Heart Attack. Angina Chest Pain. Diagnosing a Heart Attack. Treatment of a Heart Attack. Life After a Heart Attack. Heart Attack Tools and Resources. Our digital magazine delivers helpful articles and the latest news on keeping your heart healthy. Subscribe to Heart Insight magazine and the monthly e-newsletter today! NOTE: All fields required unless indicated as optional. When these functions fall out of alignment because of sleep deprivation, people operate at a far lower level of performance than they would if they were well rested.
Czeisler goes on to observe that corporations have all kinds of policies designed to protect employees—rules against smoking, sexual harassment, and so on—but they push people to the brink of self-destruction by expecting them to work too hard, too long, and with too little sleep. Czeisler recommends that companies institute corporate sleep policies that discourage scheduled work beyond 16 consecutive hours as well as working or driving immediately after late-night or overnight flights. A sidebar to this article summarizes the latest developments in sleep research.
At am on June 10, , Israel Lane Joubert and his family of seven set out for a long drive home following a family reunion in Beaumont, Texas. He survived, but his wife and five of his six children were killed.
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The Joubert tragedy underscores a problem of epidemic proportions among workers who get too little sleep. In the past five years, driver fatigue has accounted for more than 1. The general effect of sleep deprivation on cognitive performance is well-known: Stay awake longer than 18 consecutive hours, and your reaction speed, short-term and long-term memory, ability to focus, decision-making capacity, math processing, cognitive speed, and spatial orientation all start to suffer. Cut sleep back to five or six hours a night for several days in a row, and the accumulated sleep deficit magnifies these negative effects.
Sleep deprivation is implicated in all kinds of physical maladies, too, from high blood pressure to obesity. Nevertheless, frenzied corporate cultures still confuse sleeplessness with vitality and high performance. A road warrior lives out of a suitcase while traveling to Tokyo, St. Louis, Miami, and Zurich, conducting business in a cloud of caffeinated jet lag. People like this put themselves, their teams, their companies, and the general public in serious jeopardy, says Dr. He notes that while corporations have all kinds of policies designed to prevent employee endangerment—rules against workplace smoking, drinking, drugs, sexual harassment, and so on—they sometimes push employees to the brink of self-destruction.
Czeisler understands the physiological bases of the sleep imperative better than almost anyone. In this edited interview with senior editor Bronwyn Fryer, Czeisler observes that top executives now have a critical responsibility to take sleeplessness seriously. What does the most recent research tell us about the physiology of sleep and cognitive performance? Four major sleep-related factors affect our cognitive performance.
The kinds of work and travel schedules required of business executives today pose a severe challenge to their ability to function well, given each of these factors.
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Throughout the waking day, human beings build up a stronger and stronger drive for sleep. The fact is that when we are drowsy, the brain can seize control involuntarily. Clif Saper at Harvard Medical School. Once that happens, sleep seizes the brain like a pilot grabbing the controls. The second major factor that determines our ability to sustain attention and maintain peak cognitive performance has to do with the total amount of sleep you manage to get over several days.
If you get at least eight hours of sleep a night, your level of alertness should remain stable throughout the day, but if you have a sleep disorder or get less than that for several days, you start building a sleep deficit that makes it more difficult for the brain to function.
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This greatly lengthens reaction time, impedes judgment, and interferes with problem solving. This circadian pacemaker sends out its strongest drive for sleep just before we habitually wake up, and its strongest drive for waking one to three hours before we usually go to bed, just when the homeostatic drive for sleep is peaking.
The circadian pacemaker may help us to focus on that big project by enabling us to stay awake throughout the day in one long interval and by allowing us to consolidate sleep into one long interval at night. The caffeine in the coffee temporarily blocks receptors in the brain that regulate sleep drive. Thereafter, the circadian pacemaker sends out a stronger and stronger drive for waking as the day progresses. As the homeostatic drive dissipates midway through the sleep episode, the circadian drive for sleep increases toward morning, maintaining our ability to obtain a full night of sleep.
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After our usual wake time, the levels of melatonin begin to decline. Normally, the two mutually opposing processes work well together, sustaining alertness throughout the day and promoting a solid night of sleep. There is a transitional period between the time you wake up and the time your brain becomes fully functional. Most top executives are over We are more easily awakened by disturbances such as noise from the external environment and from our own increasing aches and pains.
Another thing that increases with age is the risk of sleep disorders such as restless legs syndrome, insomnia, and sleep apnea—the cessation of breathing during sleep, which can occur when the airway collapses many times per hour and shuts off the flow of oxygen to the heart and brain, leading to many brief awakenings. Many people gain weight as they age, too.
Some researchers speculate that the epidemic of obesity in the U. Moreover, sleep-disordered breathing increases the risk of high blood pressure and heart disease due to the strain of starving the heart of oxygen many times per hour throughout the night. As we age, the circadian window during which we maintain consolidated sleep also narrows. Attempting to sleep at an adverse circadian phase—that is, during our biological daytime—becomes much more difficult.
Thus, if you take a 7 pm flight from New York to London, you typically land about midnight in your home time zone, when the homeostatic drive for sleep is very strong, but the local time is 5 am.
Exposure to daylight—the principal circadian synchronizer—at this time shifts you toward Hawaiian time rather than toward London time. In this circumstance, the worst possible thing you can do is rent a car and drive to a meeting where you have to impress people with your mental acuity at the equivalent of 3 or 4 in the morning.
You might not even make the meeting, because you very easily could wrap your car around a tree. So sleep deprivation, in your opinion, is a far more serious issue than most executives think it is. Yes, indeed. Putting yourself or others at risk while driving or working at an impaired level is bad enough; expecting your employees to do the same is just irresponsible.
It amazes me that contemporary work and social culture glorifies sleeplessness in the way we once glorified people who could hold their liquor. We now know that 24 hours without sleep or a week of sleeping four or five hours a night induces an impairment equivalent to a blood alcohol level of. The analogy to drunkenness is real because, like a drunk, a person who is sleep deprived has no idea how functionally impaired he or she truly is.
Consider the risk of occupational injury and driver fatigue. In the U. Countless innocent people are hurt. I would not want to be the CEO of the company bearing responsibility for those preventable deaths. Sleep deprivation among employees poses other kinds of risks to companies as well. With too little sleep, people do things that no CEO in his or her right mind would allow. People in executive positions should set behavioral expectations and develop corporate sleep policies, just as they already have concerning behaviors like smoking or sexual harassment.
At least 11 consecutive hours of rest should be provided every 24 hours. Furthermore, employees should not be scheduled to work more than 60 hours a week and not be permitted to work more than 80 hours a week. When working at night or on extended shifts, employees should not be scheduled to work more than four or five consecutive days, and certainly no more than six consecutive days.
People need at least one day off a week, and ideally two in a row, in order to avoid building up a sleep deficit. Now, managers will often rationalize overscheduling employees. Of course, some circumstances may arise in which you need someone to remain at work for more than 16 consecutive hours. Companies also need executive policies.
For example, I would advise executives to avoid taking red-eye flights, which severely disrupt sleep. If someone must travel overnight internationally, the policy should allow the executive to take at least a day to adapt to the sleep deprivation associated with the flight and the new time zone before driving or conducting business. Such a policy requires some good schedule planning, but the time spent making the adjustments will be worth it, for the traveler will be more functional before going into that important meeting.
And the sleep policy should not permit anyone, under any circumstances, to take an overnight flight and then drive to a business meeting somewhere—period.