A US study analysing data from more than 1,700 adults has found that those reporting excessive daytime sleepiness were 52 per cent more likely to already have hypertension and 74 per cent more likely to develop it over time. The risk more than doubled for individuals who also took 30 minutes or longer to fall asleep at night. Separately, cardiologists in India are documenting a pattern in which men in their 30s and 40s present with heart attacks without extremely elevated traditional risk markers, but with a long history of relentless work pressure, irregular sleep, and unaddressed emotional strain.

Viewed from clinical practice in New Delhi and New York, the mechanism linking these trends is chronic stress. When the body remains in a state of heightened alert, stress hormones such as cortisol and adrenaline keep blood pressure elevated and inflammation builds in the vessels, gradually accumulating arterial plaque. Neuropsychologist Sanam Hafeez, based in the United States, describes a phenomenon termed sunset anxiety, in which the absence of daytime distractions allows suppressed worries to surface at dusk, disrupting sleep and amplifying the physiological toll. A commentary from Argentina notes that stress often arises not from excessive thinking but from years of ignoring one’s own emotions and living disconnected from personal purpose, a condition that leaves the body speaking for an exhausted soul.

Psychologists in Indonesia point to behavioural patterns that both mask and compound the problem. Individuals who pack their schedules to avoid being alone, engage in many shallow interactions but few deep conversations, or use their phones to seek validation rather than connection often display subtle signs of loneliness and egocentrism. The inability to set polite but firm boundaries—using phrases such as “I need to consider this first” or “I understand your view, but I see it differently”—further erodes self-esteem and deepens emotional fatigue. Those who maintain lifelong friendships, by contrast, consistently make small gestures of contact and practise genuine listening, which provides emotional validation and buffers against isolation.

The next step, according to researchers and clinicians, is to treat stress and emotional health as modifiable cardiac risk factors, not lifestyle extras. Indian cardiologists recommend routine cardiac check-ups from the early thirties for those in demanding jobs, alongside thirty minutes of daily movement, protected sleep, and short breaks during long work hours. US sleep researchers urge physicians to look beyond sleep apnoea when assessing patients with unusual daytime sleepiness. Practical psychological strategies—setting time limits for decisions, writing down unfinished tasks to offload mental burden, and accepting that not everything must be completed in a single day—are gaining traction as low-cost interventions to interrupt the cycle of overthinking and physiological strain.