Heart Failure and Sleep Disorders

Medically Reviewed By William C. Lloyd III, MD, FACS

Both insomnia and sleep apnea are common among people with heart failure.

Middle aged man asleep in bed near clock

Your heart’s job is to pump oxygen-rich blood out to your body. All of your organs and tissues need oxygen and nutrients from blood to do their various jobs. If you’ve been diagnosed with heart failure, that means your heart isn’t pumping well enough to supply your body with the blood it needs. You might have already noticed you get short of breath easily and feel more tired than usual. One reason why you might be tired is that heart failure and sleep disorders are closely connected.

One in three people with heart failure also have insomnia. Sleep apnea–pauses in breathing throughout the night–is another common complaint with heart failure. If you don’t feel well-rested when you wake up or your bed partner says you snore, these symptoms are worth bringing up to your doctor.

The Heart Failure Sleep Disorder Connection

Heart failure and sleep disorders like insomnia and sleep apnea go hand in hand. Insomnia makes it hard to fall asleep or stay asleep the whole night. Heart failure symptoms like difficulty breathing and pain may be keeping you awake. Poor sleep also can be a side effect of medications you take to treat heart failure, or from the stress of living with a chronic disease.

Sleep apnea causes you to stop breathing many times each night. Some of these pauses can limit your airflow for several seconds. If you have sleep apnea, you might notice that you wake up gasping for air, or that your bed partner complains about your snoring.

Sleep apnea comes in two forms:

  • Obstructive sleep apnea is caused by a blockage in your upper airway. When you have heart failure, fluid buildup in your neck can block your airway.
  • Central sleep apnea occurs when your brain doesn’t send signals to the muscles that control your breathing. This type of sleep apnea is also more common in people with heart failure.

When you have trouble sleeping at night, you might feel groggy the next day. A lack of sleep can also make it harder for you to care for your health. Having a sleep disorder increases your risk of having complications or dying from heart failure. That’s why it’s so important to treat both heart failure and sleep apnea.

Getting More Sleep with Heart Failure

If you’re sleepy during the day, or you snore or gasp for air at night, talk to your doctor. They might refer you to a sleep specialist for a sleep study: while you sleep, either at home or at a sleep center, machines monitor functions like your breathing, heart rate, and oxygen level. A sleep study can pinpoint whether you have a sleep disorder, and if so, which one.

Continuous positive airway pressure (CPAP) is the main treatment for obstructive sleep apnea. CPAP involves wearing a mask while you sleep that fits over your nose and mouth; the mask is connected by a tube to a machine that gently pushes air into your throat to keep your airway open. Not only does CPAP treat sleep apnea, but it also improves the heart’s pumping ability.

Here are a few other tips to help you sleep more soundly:

  • Keep consistent sleep hours. Try to go to bed and wake up at the same time every day, including on the weekends.
  • Make sure your bedroom is quiet, cool, and comfortable.
  • Limit caffeine and alcohol, especially before bedtime.
  • Do something relaxing, like meditation or yoga, before bed to soothe you into sleep.
  • Try to exercise every day. It’s good for your heart, it will help you sleep better, and it could help you lose weight, which can improve your sleep quality and your heart health.

Also make sure you’re on the right treatment for heart failure. Some research suggests that treating heart failure with diuretics, exercise, or a pacemaker can improve sleep apnea, too.

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  4. Sleep Apnea. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/sleep-apnea
  5. Osman AM, Carter SG, Carberry JC, et al. Obstructive sleep apnea: current perspectives. Nature and science of sleep. 2018; 10:21-34. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5789079/
  6. Sleep Apnea and Heart Disease. Sleep Foundation. https://www.sleepfoundation.org/sleep-apnea/sleep-apnea-linked-heart-disease
  7. 10 Tips to Beat Insomnia. NHS. https://www.nhs.uk/live-well/sleep-and-tiredness/10-tips-to-beat-insomnia/
Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Nov 3
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