Most doctors recommend that all women, regardless of risk, focus first and foremost on less sexy but tried-and-true preventive measures. "I'd be happy as a clam sitting on the couch watching TV all the time," says Ana Dierkhising, 39, a real-estate agent in San Francisco who has had diabetes since childhood, so knows she can't. She works out regularly with a group of women and last year ran a half marathon.

Andrews admits to a few weak links in her pre-heart attack routine. Now, in about taking her meds, she's watching her sodium intake and taking daily walks with her husband when the weather permits. She's also working out on the treadmill as part of her cardiac rehabilitation at the Cleveland Clinic and plans to keep it up.

Andrews is spreading the word, too, in the hopes of keeping her daughter and sister safe. "The woman at highest risk is the one who doesn't know she's at risk," says Duke University cardiologist pamela Douglas. She's apt to take no action at all

A few nights without sleep can not only make people tired and , but may actually put the brain into a primitive "fight or flight" state, researchers said on Wednesday.

Brain images of otherwise healthy men and women showed two full days without sleep seemed to rewire their brains, re-directing activity from the calming and rational prefrontal cortex to the "fear center" -- the amygdala.

"It's almost as though, without sleep, the brain had reverted back to more primitive patterns of activity, in that it was unable to put emotional experiences into context and produce controlled, appropriate responses," said Matthew Walker of the University of California Berkeley, who led the study.

That a lack of sleep can make people grumpy is hardly news. "We all know implicitly the link between bad sleep the night before and bad mood the next day. We are just adding the brain basis to what we knew," Walker said in a telephone interview.

Walker and colleagues at Harvard Medical School used functional magnetic resonance imaging, which can scan brain activity in real time, to see what was going on in the brains of their 26 young adult volunteers.

Half were kept awake for a day, a night and another full day. The other half slept as normal.

Writing in the journal Current Biology, Walker's team said they noticed profound changes in the brain activity of those volunteers who stayed up.

"We found a strong overreaction from the emotional centers of the brain," Walker said. "It was almost as if the brain had been rewired, and connected to the fright, flight or fight area in the brain stem."


And lab workers noticed a difference in the behavior of the sleep-deprived volunteers.

"They seemed to swing like a pendulum between the broad spectrum of emotions," Walker said. "They would go from being remarkably upset at one time to where they found the same thing funny. They were almost giddy -- punch drunk."

Next Walker wants to test people who are chronically sleep-deprived, perhaps by letting them have just 5 hours of sleep over several days. The average adult needs 7 to 9 hours of sleep a night.

He said the findings may shed light on psychiatric diseases. "This is the first set of experiments that demonstrate that even healthy people's brains mimic certain pathological psychiatric patterns when deprived of sleep."