Thursday, June 24, 2010

What killed Ranjan Das, and Lessons for Night Birds

A month ago, many of us heard about the sad demise of Ranjan Das from

Bandra, Mumbai. Ranjan, just 42 years of age, was the CEO of SAP-Indian

Subcontinent, the youngest CEO of an MNC in India . He was very active

in sports, was a fitness freak and a marathon runner. It was common to

see him run on Bandra's Carter Road . Just after Diwali, on 21st Oct, he

returned home from his gym after a workout, collapsed with a massive

heart attack and died. He is survived by his wife and two very young


It was certainly a wake-up call for corporate India . However, it was

even more disastrous for runners amongst us. Since Ranjan was an avid

marathoner (in Feb 09, he ran Chennai Marathon at the same time some of

us were running Pondicherry Marathon 180 km away), the question came as

to why an exceptionally active, athletic person succumb to heart attack

at 42 years of age.

Was it the stress?

A couple of you called me asking about the reasons. While Ranjan had

mentioned that he faced a lot of stress, that is a common element in

most of our lives. We used to think that by being fit, one can conquer

the bad effects of stress. So I doubted if the cause was stress.

The Real Reason

However, everyone missed out a small line in the reports that Ranjan

used to make do with 4-5 hours of sleep. This is an earlier interview

of Ranjan on NDTV in the program 'Boss' Day Out':

Here he himself admits that he would love to get more sleep (and that

he was not proud of his ability to manage without sleep, contrary to

what others extolled).

The Evidence

Last week, I was working with a well-known cardiologist on the subject

of ‘Heart Disease caused by Lack of Sleep’. While I cannot share

the video nor the slides because of confidentiality reasons, I have

distilled the key points below in the hope it will save some of our lives.

Some Excerpts:

* Short sleep duration (<5 or 5-6 hours) increased risk for high BP by

350% to 500% compared to those who slept longer than 6 hours per

night. Paper published in 2009.

As you know, high BP kills.

* Young people (25-49 years of age) are twice as likely to get high BP

if they sleep less. Paper published in 2006.

* Individuals who slept less than 5 hours a night had a 3-fold

increased risk of heart attacks. Paper published in 1999.

* Complete and partial lack of sleep increased the blood concentrations

of High sensitivity C-Reactive Protein (hs-cRP), the strongest

predictor of heart attacks. Even after getting adequate sleep later,

the levels stayed high!!

* Just one night of sleep loss increases very toxic substances in body

such as Interleukin-6 (IL-6), Tumour Necrosis Factor-Alpha (TNF-alpha)

and C-reactive protein (cRP). They increase risks of many medical

conditions, including cancer, arthritis andheart disease. Paper

published in 2004.

* Sleeping for <=5 hours per night leads to 39% increase in heart

disease. Sleeping for <=6 hours per night leads to 18% increase in

heart disease. Paper published in 2006.

Ideal Sleep

For lack of space, I cannot explain here the ideal sleep architecture. But

in brief, sleep is composed of two stages: REM (Rapid Eye Movement)

and non-REM. The former helps in mental consolidation while the latter

helps in physical repair and rebuilding. During the night, you alternate

between REM and non-REM stages 4-5 times.

The earlier part of sleep is mostly non-REM. During that period, your

pituitary gland releases growth hormones that repair your body. The

latter part of sleep is more and more REM type.

For you to be mentally alert during the day, the latter part of sleep

is more important. No wonder when you wake up with an alarm clock after

5-6 hours of sleep, you are mentally irritable throughout the day (lack

of REM sleep). And if you have slept for less than 5 hours, your body

is in a complete physical mess (lack of non-REM sleep), you are tired

throughout the day, moving like a zombie and your immunity is way down

(I’ve been there, done that)

Finally, as long-distance runners, you need an hour of extra sleep to

repair the running related damage.

In conclusion:

Barring stress control, Ranjan Das did everything right: eating proper

food, exercising (marathoning!), maintaining proper weight. But he

missed getting proper and adequate sleep, minimum 7 hours. In my opinion,

that killed him.

If you are not getting enough sleep (7 hours), you are playing with fire,

even if you have low stress.

I always took pride in my ability to work 50 hours at a stretch whenever

the situation warranted. But I was so spooked after seeing the scientific

evidence last week that since Saturday night, I ensure I do not even

set the alarm clock under 7 hours. Now, that is a nice excuse to get

some more sleep. :)

Unfortunately, Ranjan Das is not alone when it comes to missing

sleep. Many of us are doing exactly the same, perhaps out of

ignorance. Please forward this mail to as many of your colleagues as

possible, especially those who might be short-changing their sleep. If

we can save even one young life because of this email, I would be the

happiest person on earth.

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