Sleep is on the cholesterol list, and so is stress

Cholesterol is a waxy, fat-like substance in every cell, and you need some of
it. Too much in the blood sticks to artery walls and narrows or blocks them,
which is the road to coronary artery disease.

The liver makes it, and it travels on lipoproteins:

• LDL, the "bad" one — a high level builds cholesterol up in the arteries
• HDL, the "good" one — it carries cholesterol back to the liver, which
  removes it from the body

So there are two levers: lower LDL, raise HDL.

The six lifestyle changes

Most lists stop at four. All six are here, and the last two are the ones
people do not associate with cholesterol at all.

1. Heart-healthy eating. Limit saturated and trans fats; eat and drink
   only enough calories to stay at a healthy weight; choose a variety of
   nutritious foods — fruits, vegetables, whole grains, lean meats. The
   Therapeutic Lifestyle Changes diet and the DASH eating plan are two
   examples that lower cholesterol.
2. Aiming for a healthy weight. Losing weight lowers LDL and raises HDL,
   especially in people with metabolic syndrome.
3. Regular physical activity. Studies show it lowers LDL and triglycerides
   and raises HDL. Ask your provider what level is right for you before
   starting.
4. Quitting smoking. This raises HDL — and since HDL removes LDL from
   the arteries, more HDL helps lower LDL. One change, both levers.
5. Managing stress. Research shows **chronic stress can raise LDL and
   lower HDL.**
6. Getting enough good-quality sleep. **7 to 9 hours a night lowers your
   risk of high LDL and high total cholesterol.**

Medicines

For some people lifestyle changes alone are not enough. There are **several
types** of cholesterol medicine; they work in different ways and have
different side effects, so ask your provider which one suits you.

Even on medicine, you still need to continue the lifestyle changes. The
drug does not replace them.

Beyond that

Lipoprotein apheresis is a further treatment used for some people with
familial hypercholesterolemia, an inherited condition causing very high
blood cholesterol.

Source: MedlinePlus, U.S. National Library of Medicine.