Staying up past your bedtime could increase risk of stroke, diabetes and heart disease

But what if your normal bedtime is 2-3am? I'm not worrying about this, I had practically a zero risk for stroke and I had one.  

This is probably the same definition of normal as when your doctors tell you you can resume normal activities. But I normally do whitewater canoeing and skydiving, good to know I can resume those after open heart surgery. 

Staying up past your bedtime could increase risk of stroke, diabetes and heart disease

Staying up past your bedtime might increase your risk of stroke, diabetes and heart disease, research suggests.
Going to bed even one minute past your regular time can significantly affect your resting heart rate and carry over into the next day, findings show.
The findings could even explain why shift workers suffer from poor health.
Scientists have stressed the importance of healthy sleep habits recommending at least seven hours each night, linking a lack of sleep to an increase in multiple health conditions.
A new study now shows whether or not you go to bed on time could also have an effect on your health.
US researchers at the University of Notre Dame in Indiana studied the correlation between bedtime regularity and resting heart rate (RHR) using Fitbit data.
They found that people going to bed even 30 minutes later than their usual bedtime presented a significantly higher resting heart rate that lasted into the following day.
Lead study author Professor Nitesh Chawla, from the University of Notre Dame, said: "Despite increasing awareness of how critical sleep is to our health, getting a good night's rest remains increasingly difficult in a world that's always 'on.'
"Responding to emails at all hours, news cycles that change with every tweet and staring endlessly into the blue light of cell phone, tablet and computer screens.
"We already know an increase in resting heart rate means an increased risk to cardiovascular health.
"Through our study, we found that even if you get seven hours of sleep a night, if you're not going to bed at the same time each night, not only does your resting heart rate increase while you sleep, it carries over into the next day."
Prof Chawla and his team analysed data collected via Fitbit from 557 college students over the course of four years.
They recorded more than 255,000 sleep sessions measuring bedtimes, sleep and resting heart rate.
Significant increases in RHR were found when individuals went to bed anywhere between one and 30 minutes later than their normal bedtime.
The later they went to bed, the higher the increase in RHR and rates remained higher the following day.
Prof Chawla said: "Surprisingly, going to bed earlier than one's standard bedtime also showed signs of increasing RHR though it depended on just how early.
"Going to bed 30 minutes earlier than usual appeared to have little effect, while going to bed more than a half hour earlier significantly increased RHR."
But in cases of earlier bedtimes, RHR levelled out during the sleep session.
Circadian rhythms, medications and lifestyle factors all come into play when it comes to healthy sleep habits, but researchers said it is vital to consider consistency as well.
Prof Chawla added: "For some, it may be a matter of maintaining their regular 'work week' bedtime through the weekend.
"For shift workers and those who travel frequently, getting to bed at the same time each night is a challenge.
"Establishing a healthy bedtime routine as best you can is obviously step number one. But sticking to it is just as important."
Findings were published in the journal Nature.

Chronotherapy with conventional blood pressure medications improves management of hypertension and reduces cardiovascular and stroke risks

If I'm reading this correctly it would seem better to take your pills before you go to bed.
chronotherapy -  The practice of timing drugs at certain times of the day
Do not undertake any changes without talking to your doctor.  You'll know how up-to-date your doctor is if they can reference this study when talking to you.
http://www.nature.com/hr/journal/vaop/ncurrent/full/hr2015142a.html

Ramón C Hermida, Diana E Ayala, Michael H Smolensky, José R Fernández, Artemio Mojón and Francesco Portaluppi

Abstract

Correlation between blood pressure (BP) and target organ damage, vascular risk and long-term patient prognosis is greater for measurements derived from around-the-clock ambulatory BP monitoring than in-clinic daytime ones. Numerous studies consistently substantiate the asleep BP mean is both an independent and a much better predictor of cardiovascular disease (CVD) risk than either the awake or 24 h means. Sleep-time hypertension is much more prevalent than suspected, not only in patients with sleep disorders, but also among those who are elderly or have type 2 diabetes, chronic kidney disease or resistant hypertension. Hence, cost-effective adequate control of sleep-time BP is of marked clinical relevance. Ingestion time, according to circadian rhythms, of hypertension medications of six different classes and their combinations significantly affects BP control, particularly sleep-time BP, and adverse effects. For example, because the high-amplitude circadian rhythm of the renin–angiotensin–aldosterone system activates during nighttime sleep, bedtime vs. morning ingestion of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers better reduces the asleep BP mean, with additional benefit, independent of medication terminal half-life, of converting the 24 h BP profile into more normal dipper patterning. The MAPEC (Monitorización Ambulatoria para Predicción de Eventos Cardiovasculares) study, first prospective randomized treatment-time investigation designed to test the worthiness of bedtime chronotherapy with 1 conventional hypertension medications so as to specifically target attenuation of asleep BP, demonstrated, relative to conventional morning therapy, 61% reduction of total CVD events and 67% decrease of major CVD events, that is, CVD death, myocardial infarction, and ischemic and hemorrhagic stroke. The MAPEC study, along with other earlier conducted less refined trials, documents the asleep BP mean is the most significant prognostic marker of CVD morbidity and mortality; moreover, it substantiates attenuation of the asleep BP mean by a bedtime hypertension treatment strategy entailing the entire daily dose of 1 hypertension medications significantly reduces CVD risk in both general and more vulnerable hypertensive patients, that is, those diagnosed with chronic kidney disease, diabetes and resistant hypertension.

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Bedtime stroke therapy #2

Started something new last night, When I was still getting OT my therapist gave me this to try to counteract my spasticity. Clasp my hands together and put them behind my neck while lying on my back, trying to let my left arm down until it reaches the bed. It starts out at 45 degrees and maybe 15 minutes later has drifted down about 3 inches. While waiting I wiggle the left arm up and down to prove that I can control it. I'm hoping that this eventually will allow me to hold a phone to my ear with my left hand. I know its stupid but we have to do these stupid ideas because no one has written up case studies or come up with protocols that work for those of us that still have deficits after the spontaneous recovery.

Bedtime stroke therapy#1.5 to be researched

At night in bed before I go to sleep I attempt a number of exercises. My latest is a repeat of what I used to do my first year - at that time this was extremely difficult. I hold my left arm straight up and move it in circles above my body, I start with small circles and go to large circles that reach almost to the bed. This is not very hard to do right now, I can do this very smoothly. A good research experiment would be to put me on a slant board and see at what point the circles no longer are easy and smooth as the board goes from parallel to the floor to perpendicular. Then come up with a hypothesis as to why this occurs. I know when I am standing upright trying to do the same circles is impossible due to spasticity. It would be a simple experiment for any PT or OT. At what point in the degree of slope does the circle deteriorate? Who will accept the challenge? William M. Landau?
Many others are available, just ask me.

Bedtime stroke therapy#1

As I go to bed each night I try to do some exercises. The current one is to lay my left arm at 90 degrees to my body(this forces my pectoralis to relax) and from the forearm pointing straight up, lower the arm to level or below the bed. It is hanging over the bed at this time. My first one takes a minute or so to accomplish because I have to verbally abuse my spastic bicep to stop behaving like a spoiled brat, getting his way all the time. I do between 25 and 50 a night. After that is done I work on just raising and lowering the forearm 4-6 inches, this goes much faster and I'll change the position in order to cover the full range of straightening the arm.. After that I try to position the arm so the pectoralis muscle is straightened out, this occurs by grabbing the spindles in the headboard and pulling the whole arm over my head, the arm is bent but the bicep spasticity was worked on earlier. This is called PMS(prolonged muscle stretch), posted about here:
http://oc1dean.blogspot.com/2011/04/prolonged-muscle-stretch-on-spastic.html

But nothing here has any scientific basis so don't even bother to ask your doctor or therapist about it. This comes from the do-it-yourself therapy proposed by Dr. Steven Wolf;
http://oc1dean.blogspot.com/2011/03/problem-solving-for-stroke-rehab.html