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If you’re living with heart disease, you may also experience sleeping problems, particularly insomnia. Insomnia — difficulty falling or staying asleep — is common in people with heart disease. While a number of factors can affect your ability to get a good night’s sleep, symptoms of heart disease or side effects from treatments can make quality sleep even harder to come by.
As one MyHeartDiseaseTeam member shared, “I’ve been dealing with insomnia since last year, and it isn’t fun at all. I think it feels worse than my heart failure right now.”
In this article, we’ll explore what insomnia is, how it’s connected to heart disease, and what you can do to get a better night’s rest.
Insomnia is a sleep disorder that makes it hard to fall asleep, stay asleep, or both. Insomnia can lead to fatigue, daytime sleepiness, and irritability or mood changes.
Insomnia can be short term (lasting several days or weeks) or long term (lasting three months or more). According to the American Academy of Sleep Medicine, about 12 percent of Americans live with chronic insomnia.
Adults typically need at least seven hours of sleep each night. Lack of sleep can contribute to several health issues. It can increase your risk for obesity and type 2 diabetes, which are risk factors for heart disease — or worsen those conditions. Severe sleep deprivation can cause thought disorders, concentration difficulties, and disturbances in heart rhythm or function.
Insomnia is common among people living with cardiovascular conditions such as heart disease. A 2021 research study found that 45 percent of outpatients with coronary heart disease experienced insomnia.
You may have wondered, “Does insomnia cause high blood pressure?” Research suggests it can. Insomnia has been linked to increased hypertension (high blood pressure), coronary heart disease (narrowing of the blood vessels that supply the heart), and heart failure (when the heart can’t pump effectively).
There are several reasons why people with heart disease may struggle with insomnia.
Heart disease symptoms such as chest pain and discomfort, trouble breathing, and gastrointestinal issues can make it harder to find a comfortable sleeping position. Heart palpitations can also interfere with sleep.
Conditions like orthopnea (shortness of breath) can sometimes worsen when you lie down, leading to poor sleep. Some people may be awakened by chest pain or paroxysmal nocturnal dyspnea (sudden shortness of breath during sleep due to heart weakness). Orthopnea and paroxysmal nocturnal dyspnea affect people with heart failure.
Mental health problems are common in people with chronic conditions like heart disease. Concerns about one’s health or fear of a cardiac event can make it hard to relax. The 2021 study of people with heart disease found that anxiety was the most common cause of insomnia.
If you have heart disease, sleeping on your back may make it harder to breathe and could lead to sleep disturbances. Many people find that sleeping on their side — especially the right side — is more comfortable and helps them sleep better. Finding a position that supports your breathing can improve sleep hygiene and reduce the strain that lack of sleep puts on your heart.
Certain treatments for heart disease — including medications and surgery — may contribute to insomnia:
Never stop taking your heart disease medications without talking to your doctor first. Stopping these medications suddenly can be dangerous and cause serious complications.
Other heart disease treatments can also impact sleep. Recovering from surgery often takes several weeks. During recovery, chest pain, discomfort, or general fatigue can make lying down and falling asleep difficult. These symptoms may also cause short-term insomnia.
Even though insomnia can add stress to your body and complicate the management of heart disease or other health conditions, there are steps you can take to improve your sleep.
Try to create a sleep schedule where you go to sleep and wake up at the same time every day, even on weekends. A consistent routine helps your body adjust to a natural rhythm, which can help improve insomnia.
Your sleep schedule can include a calming bedtime ritual to wind down. This could include reading, taking a bath, gentle stretching, or listening to soothing music.
Short, early naps are best. If you nap, keep it to 10 to 30 minutes, and avoid late-day naps.
Make your bedroom a place that supports quality sleep. Keep the space dark, quiet, and cool. Avoid bright lights and screens at least an hour before bedtime. A calm, low-stimulation environment can help ensure better sleep quality.
Regular exercise or physical activity can promote healthy sleep. Staying active during the day helps tire your body and mind, making it easier to fall asleep at night. For most people, moderate-intensity exercise in the evening doesn’t interfere with sleep as long as you finish a few hours before bedtime.
Start with cognitive behavioral therapy for insomnia (CBT-I). If that isn’t enough, a short course of prescription sleep medicine can help; use the lowest dose for the shortest time and plan how to stop. Avoid routine “PM” antihistamine sleep aids. Melatonin is not a treatment for chronic insomnia in adults. Always check with your doctor or pharmacist to be sure any sleep aid is safe with your heart medicines.
Limit or avoid caffeine, nicotine, and alcohol in the hours leading up to bedtime. Caffeine late in the day can keep your brain alert and make it harder for you to fall asleep. Although a bit of alcohol may make you sleepy, it often leads to lighter, disrupted sleep.
If you’re struggling with sleep problems, talk to your healthcare provider. They can determine whether you have insomnia or another sleep disorder, such as obstructive sleep apnea.
Sleep apnea causes breathing to stop and start during sleep. It’s often caused by a blocked airway and is commonly associated with loud snoring. People with obstructive sleep apnea are at a higher risk of high blood pressure, cardiovascular disease, and strokes, making diagnosis and treatment essential. Untreated sleep apnea can also make recovering from a heart attack more challenging.
Mild sleep problems may improve with lifestyle changes, better sleep habits, or adjusting your sleep position, while more severe cases often require medication or care from a sleep specialist.
Some members of MyHeartDiseaseTeam find it helpful to track their sleep patterns with a sleep diary. Recording when you fall asleep, how often you wake up, and how rested you feel in the morning can help your doctor better understand how to help you get enough sleep.
Relaxing the mind and body can help you get a good night’s sleep. Research has found that meditation can help improve sleep quality and reduce insomnia. Drinking herbal tea in the afternoon or evening may also promote relaxation and better sleep.
Some people use white noise to block out sounds that could disrupt sleep patterns. White noise machines, apps, or online recordings can provide consistent, soothing sounds that promote relaxation.
A calming evening routine can make all the difference between tossing and turning and getting a good night’s sleep. If you’re having trouble sleeping, ask your healthcare provider or a sleep specialist for help.
On MyHeartDiseaseTeam, people share their experiences with heart disease, get advice, and find support from others who understand.
What are your tips for managing insomnia with heart disease? Let others know in the comments below.
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I have difficulty falling asleep. Before heart attack I was usually asleep by 9:00 and up by 6;00 at the latest. My sleep pattern is gone and I just don't worry about it. When my body shuts down I… read more
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