Forty years ago this week we lost Marty Robbins at the tragically young age of 57. Robbins was one of the top country singers and songwriters from the 1940s to the 1980s, and today you will still hear his “El Paso,” “Big Iron” and many other classics. He won two Grammy Awards and was elected to the Country Music Hall of Fame and the Nashville Songwriters Hall of Fame. At the same time he was a successful stock car racer who was in 36 NASCAR races from 1966 to 1982 and had six top-10 finishes.

At age 44, he suffered his first heart attack and in 1982, at age 57, he died after his third heart attack. He did not have a lot of obvious heart attack risk factors: He was not overweight, did not have a protruding belly (a sign of a fatty liver) and was married to only one woman for 35 years. However, he did have lifelong sleep problems and took medications to help him sleep. Even after he had established himself as a popular country and western star, he kept a crazy schedule of NASCAR races followed by midnight performances at the Grand Ole Opry, so he was chronically sleep-deprived.

Driven from an Early Age
His incredible drive to be the best and to succeed in his career in music and his hobby of stock car racing was probably fueled by memories of the abuses and severe poverty of his childhood. He was one of nine children born into poverty in Arizona, to an alcoholic father who left his mother when Marty was 12 years old. The family moved frequently in the Arizona desert and even lived in tents rather than in a house. He never was graduated from high school.  He lived as a hobo, worked a variety of odd jobs, and by his late teens was guilty of petty crimes. At age 17 he joined the U.S. Navy and fought in the Pacific during World War II. While he was stationed in the Solomon Islands, he taught himself to play a guitar and began to write songs.

After leaving the navy in 1946, he returned to Arizona where he began to play in clubs, hosted a local radio show and then got a local television show. One of his show guests, Little Jimmy Dickens, helped him to get a contract with Columbia Records, which led to a recording career with more than 60 albums and 500 songs over four decades. In addition to his Grammy awards, he was named the 1960s Artist of the Decade by the Academy of Country Music.

Even with his outstanding achievements in his profession and in his hobby, he was still driven to work all the time to be the best. For example, during a NASCAR race when he was leading, he suddenly pulled off the track and came onto the pit road. His daughter ran over to him and asked what was wrong. He said that nothing was wrong; but the race was running late and he had to get to the Grand Ole Opry. The NASCAR races were on the same night that he appeared regularly on The Grand Ole Opry, so he was working the equivalent of two full-time jobs at the same time.

His Heart Attack History
In 1969, at age 44, he suffered a heart attack and was one of the first people to receive a triple-bypass operation. Incredibly, a year after his heart attack, he resumed NASCAR racing at speeds of 150 miles or more per hour. In 1974 and 1975, he suffered three major crashes and gave up racing for a while, but returned to racing in 1977. His doctors told him to stop racing after his heart attacks, but he refused to take their advice.  In 1981, at age 56, he suffered a second heart attack, but resumed racing up to November 1982, a month before his death. In 1982 at age 57, he suffered his third heart attack and had an eight-hour quadruple bypass operation in which highly-competent surgeons repaired the three bypasses from his earlier heart surgery and he also received a fourth bypass. In spite of this heroic effort by his doctors, he did not recover after the surgery and died a few days later.

Chronic Lack of Sleep is Associated with Increased Heart Attack Risk
It is common and normal for people occasionally to have difficulty falling and staying asleep at night, but if this happens to you on a regular basis and interferes with your functioning during the daylight hours, you need a medical evaluation to find the cause. Getting fewer than seven hours of sleep each night is associated with increased risk for heart attacks (J Am Coll Cardiol, Jan 2019;73(2):134-144). A review of the literature cites many studies that show that sleep deprivation is associated with high blood pressure, heart disease, and diabetes (Curr Cardiol Rev, 2010 Feb;6(1):54-61). People who sleep for fewer than seven hours a night have a 20 percent increased risk for heart disease (J Am Coll Cardiol, 2019 Sep 10;74(10):1304-1314). Inability to stay asleep at night is associated with increased risk for heart attacks for both males and females, and all races studied (Scientific Reports, Feb 7, 2022;12, 20412).

Several studies show that lack of sleep increases inflammation, a major heart attack risk factor (J Exp Med, Sept, 2022;219(11):e20220081). Researchers at Harvard Medical School did a study on mice in an effort to explain how sleep disruption can increase risk for heart attacks. They found that sleep disruption causes inflammation that can lead to heart attacks (Nature, Feb 13, 2019;566(7744):383-387). The authors found that lack of deep sleep markedly reduces production by a part of the brain called the hypothalamus of a hormone called hypocretin. Lack of hypocretin causes tiredness, decreased energy levels, and difficulty sleeping deeply. The sleep-deprived mice had high white blood cell counts signifying an overactive immune system, developed large plaques in their arteries, and had other markers of inflammation. Then the researchers gave hypocretin to the sleep-deprived mice and found that markers of inflammation and arteriosclerosis were reduced significantly. This study suggests that lack of sleep might be another major risk factor for inflammation that is associated with increased risk for heart attacks in humans.

A Lesson from Marty Robbins’s Young Death
Lots of people work long hours for money or for fame. If long working hours interferes with your getting at least seven hours of sleep each night, you should get a medical checkup to see if you are at increased risk for a heart attack or diabetes. If you are at increased risk, you may need to re-evaluate your priorities.

Marty Robbins
September 26, 1925 – December 8, 1982