Heart attacks are intimately connected to lifestyle factors so certain patterns of behaviour can determine your risk of having one. One study found that people who exhibited three insomnia-related symptoms were at a significantly higher risk of having a heart attack.

Heart attacks often conjure up images of people falling to the floor and clutching their chest in agonising pain. While the event itself can be sudden and shocking, subtle signs can indicate your likelihood of having a heart attack long before you found yourself in the grip of one. This is because the condition is strongly tied to unhealthy lifestyle habits, such as eating a poor diet and leading a sedentary lifestyle.

Prolonged sleep deprivation can also heighten your risk of having a heart attack.

One study investigated the relationship between insomnia and cardiovascular complications, such as a heart attack.

The study involved 487,200 people in China with an average age of 51.

Participants had no history of stroke or heart disease at the beginning of the study.

Participants were asked if they had any of three symptoms of insomnia at least three days per week: trouble falling asleep or staying asleep; waking up too early in the morning; or trouble staying focused during the day due to poor sleep.

A total of 11 percent of the people had difficulty falling asleep or staying asleep, 10 percent reported waking up too early and two percent had trouble staying focused during the day due to poor sleep.

The people were then followed for an average of about 10 years.

During that time, there were 130,032 cases of stroke, heart attack and other similar diseases.

People who had all three symptoms of insomnia were 18 percent more likely to develop a heart attack and other similar diseases than people who did not have any symptoms.

What's more, people who had trouble falling asleep or staying asleep were nine percent more likely to develop stroke or heart disease than people who did not have this trouble.

Heart disease, an umbrella term for conditions that narrow or block blood vessels, is the leading cause of heart attacks.

Of the 55,127 people who had this symptom, 17,650, or 32 percent, had a stroke or heart disease, compared to 112,382, or 26 percent, of the 432,073 people who did not have this symptom of insomnia.

"The link between insomnia symptoms and these diseases was even stronger in younger adults and people who did not have high blood pressure at the start of the study, so future research should look especially at early detection and interventions aimed at these groups," said study author Liming Li, MD, of Peking University in Beijing, China.

The results may be unsettling but they are also encouraging.

As Professor Li pointed out, it suggests that correcting sleep loss with behavioural interventions could go some way to warding off the threat of having a heart attack.

How to treat insomnia

According to the NHS, insomnia usually gets better by changing your sleeping habits.

The health body says to:

• Go to bed and wake up at the same time every day – only go to bed when you feel tired
• Relax at least one hour before bed – for example, take a bath or read a book
• Make sure your bedroom is dark and quiet – use thick curtains, blinds, an eye mask or ear plugs
• Exercise regularly during the day
• Make sure your mattress, pillows and covers are comfortable

How do I know if I am having a heart attack?

According to the British Heart Foundation (BHF), heart attack symptoms can vary but the most common signs of a heart attack are:

• Chest pain or discomfort that suddenly occurs and doesn’t go away. It may feel like pressure, squeezing or heaviness in your chest
• Pain that may spread to your left or right arm or may spread to your neck, jaw, back or stomach
• Feeling sick, sweaty, light-headed or short of breath.

Other less common symptoms include:

• A sudden feeling of anxiety that can feel similar to a panic attack
• Excessive coughing or wheezing due to a buildup of fluid in the lungs.

It adds: "Heart attack symptoms can persist over days, or they can come on suddenly and unexpectedly."

Express