How to Sleep Better With Atrial Fibrillation

Medically Reviewed by James Beckerman, MD, FACC on June 30, 2022
4 min read

Atrial fibrillation, or AFib, is a type of irregular heartbeat. If you have this condition, you may have a higher risk for blood clots, stroke, heart failure, and other heart problems. It is also linked to trouble sleeping. Getting a good night’s sleep is important to your health, so be sure to take steps to ensure rest and relaxation.

Everyone is different, but most adults between ages 18 and 64 need 7-9 hours of sleep a night. If you’re 65 or older, you may find you need slightly less.

What can you do to make sure you’re getting enough sleep when you have AFib?

Talk to your doctor if you suspect you have sleep apnea or another sleep-related breathing disorder. The link between AFib and obstructive sleep apnea is so strong that doctors are debating whether all people with AFib should be tested for sleep apnea.

If you have obstructive sleep apnea, you may need to sleep with a mask or use a CPAP machine to make sure you get enough oxygen at night.

Your sleeping position could be part of the problem if you have paroxysmal AFib. One study found that people who slept on their left sides reported more symptoms. This position may put more stress on your heart.

What you eat and drink – and when – can affect your sleep with AFib. Some suggestions:

  • Limit alcohol. One drink for women and two for men is considered “moderate” alcohol use. Alcohol can trigger AFib.
  • Limit caffeine. This stimulant can worsen your symptoms and interfere with sleep. It can disrupt your body’s internal clock, leading you to get less sleep. And it can make the sleep you do get less restful.

Exercise generally helps you sleep better and is good for heart health. You may be worried, though, about working out when you have AFib. It’s true that some types of exercise flood your body with adrenaline, which can worsen AFib symptoms. You need to choose your workout carefully. Talk to your doctor before you begin an exercise program. The timing of your workout may affect your sleep. Some people find that exercise too close to bedtime keeps them awake.

Some basic lifestyle changes can help you sleep better and manage AFib:

  • If you smoke, quit. One study found that people with AFib who quit smoking lowered their risk of cardiovascular disease and stroke. Smoking also is linked to insomnia and other sleep problems.
  • Maintain a healthy weight. Losing just 10% of your body weight can reduce obstructive sleep apnea symptoms.
  • Manage stress, which is known to worsen AFib symptoms and contribute to poor sleep. Studies have found that simply learning you have AFib is linked to increased anxiety and distress and, in some cases, ideas of suicide. Remedies you might consider include therapy, breathing exercises, yoga, or acupuncture.

AFib and sleep problems are closely linked, although the exact relationship between the two is complicated. Do sleep disorders cause AFib? Or is AFib a cause of sleep disorders? The research has been contradictory. The two conditions may boost each other.

One disorder researchers have looked at related to AFib is sleep apnea. When you have sleep apnea, your breathing stops and starts over and over while you’re asleep. There are two main types:

  • Obstructive sleep apnea happens when your airway closes multiple times while you’re sleeping. That can be caused by obesity, large tonsils, or changes in hormone level – for instance, during menopause. This is the most common type.
  • Central sleep apnea happens when your brain doesn’t send your body the signals it needs to breathe regularly.

Research has tied other sleep-breathing problems, called sleep-disordered breathing or SDB, to AFib. Those types of sleep-disordered breathing include:

  • Sleep-related hypoventilation disorders lead to high levels of carbon dioxide in your body. This is a result of your lungs not moving enough air in and out while you sleep. Causes can include obesity, chronic obstructive pulmonary disease (COPD), other health problems, or even medications you take for other illnesses.
  • Sleep-related hypoxia disorders cause low levels of oxygen in your body. This is usually related to a lung condition.

Studies have found that if you have both obstructive sleep apnea and persistent AFib, the treatments for your heart condition are less likely to be effective. Whether you take medication or have a procedure to shock your heart back into rhythm, your AFib is more likely to come back if you have obstructive sleep apnea.

Certain bedtime practices are helpful for everyone, not just those with AFib or at risk for developing it. They include:

  • Set a consistent bedtime.
  • Keep your bedroom quiet, dark, and cool.
  • Turn off electronic devices at least 30 minutes before bedtime.
  • Don’t go to bed unless you’re sleepy.
  • If you’re not asleep in 20 minutes, get up and do a quiet activity.
  • Limit the fluids you drink before bed.