How Are Heart Failure and Sleep Related?

Medically Reviewed by James Beckerman, MD, FACC on May 15, 2023
Written by James Roland
3 min read

The relationship between sleep and heart failure is a two-way street. Having heart failure means you're likely to have other health issues, including sleep problems. Likewise, sleep problems, including obstructive sleep apnea (OSA) and insomnia, can make your heart failure symptoms worse.

A good night's sleep is important, whether your heart is healthy or not. Rest helps your heart as well as your energy levels, thinking skills, and overall health. If you can deal with your sleep problems, you may ease the burden on your heart.

Complications of heart failure can affect your sleep. For example:

  • Chest pain and discomfort make it hard to relax and fall or stay asleep.
  • Lying in bed can make you feel short of breath.
  • You may have to get up during the night to pee.

During the day, you're standing and sitting, so extra fluid would normally settle in your legs and feet. But lie down, and it's going to move up into your chest. This can close in your lungs and airways, making it harder to breathe.

Your doctor might prescribe diuretics to help get rid of that extra fluid. But these medicines don't stop working when you sleep, which can mean interrupting your slumber for a trip or two to the bathroom.

OSA is more common among people who are overweight, but anyone can get it. The tissue in the back of your throat relaxes and blocks your airway while you sleep. You stop breathing, so your brain signals your throat muscles to contract, which opens up your airway again. This can happen dozens or even hundreds of times a night.

Your brain also releases stress hormones during these episodes. They can raise your heart rate and your blood pressure -- which raises your chance of developing heart failure or making it worse.

Researchers have also found a strong link between trouble falling or staying asleep and the likelihood of heart failure. One reason may be that insomnia triggers the body's stress response, which could weaken your heart over time.

Set yourself up for restful sleep:

  • Stick to a regular sleep/wake schedule.
  • Turn off the TV, computer, and other devices before bedtime.
  • Keep your bedroom cool and dark.
  • Avoid alcohol before bedtime and caffeine in the afternoon or evening.
  • Exercise every morning.

If you have any type of sleep issue, let your cardiologist know.

A sleep specialist can help you figure out what's going on medically, whether you're dealing with insomnia or OSA or something else, and how to treat it. One option might be continuous positive airway pressure (CPAP) -- a small machine that pumps air through a tube and mask that you wear over your mouth and nose to help keep your airway open at night.

There may not always be an easy solution, but sleep is too important to your heart and to your health in general to go without your ZZZs.