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How To Sleep Better With Congestive Heart Failure

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Dealing With Sleep Problems

How to sleep better with congestive heart failure

Following a heart attack you can feel anxious and emotional. This can affect the quality of sleep you have each night. Find out how sleep can help with your recovery and learn tips to improve your sleep.

Sleep is important to regulating mood and to memory and learning functions. Getting enough sleep will improve your ability to stay focused and on task, learn new skills and information, and may help control your weight and energy levels. Sleep assists the body by regulating hormones and contributing to a healthy immune system.

Worrying about not sleeping well is a common cause of poor sleep. Trouble getting to sleep or staying asleep will not hurt your heart in any way. You do not need to sleep more if you have a heart problem.

If you have had a problem sleeping since being told you have a heart condition, it is likely a temporary problem.

Psychologist Marie Young, talks about how sleep routine can be impacted after a heart event, and ways to manage this.

Stay On Top Of Medications

One of the most important things for managing congestive heart failure is to take medications consistently and according to instructions. Know which drugs the person youre caring for needs to take and how often they should take them. Also find out what to do if they miss a dose.

If they live alone, you can fill a pillbox with the medications they should take each day of the week. You can also post a simple daily medication schedule on their refrigerator or in their bathroom so they can check off each dose as they take it.

If your loved one has difficulty following the schedule, you might want to call them at regular intervals to make sure they have taken their medications.

Difficulty Sleeping Or Altered Sleep Patterns

Fluid buildup in the lungs due to congestive heart failure can make pets restless at night

Your pet with heart disease may not sleep well at night or be restless, and some dogs may no longer want to sleep under the covers. In pets with congestive heart failure, fluid buildup causes this disrupted sleep as breathing becomes more difficult. Dogs may sleep on their chest instead of their side or back. They may wake up in the middle of the night and seek out fresh air near a window. Close observation of their breathing will help you identify early changes in your pet.

If your pet is being treated for heart failure, a change in breathing or sleeping patterns may indicate a need for a change in medication.

HeartSmart Disclosure Statement

Dr. Freeman has received research or residency funding from, given sponsored lectures for, or provided professional services for Aratana Therapeutics, Elanco, Guiding Stars Licensing Co, LLC, Hills Pet Nutrition, Nestlé Purina PetCare, P& G Petcare , and Royal Canin.

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Best Sleeping Positions During Pregnancy

Congestive Heart Failure

If you are pregnant, sleeping on your stomach or back will be uncomfortable or impossible. You will be most comfortable sleeping on your side. Favor your left side to maximize circulation for both you and your baby. Placing a body pillow or pillow under your belly can help relieve back pain. Place another pillow between your legs and bend your knees to be even more comfortable.

Avoid This Position During Pregnancy

You’ve probably already heard this from your doctor, but just in casepregnant women should not sleep on their backs during the third trimester of pregnancy. For more than half a century, we’ve known that pregnant back sleepers are reducing blood flow to their fetus.

But only recently researchers discovered that this sleep style also raises the risk of a stillbirth, even in otherwise healthy pregnancies. You should also avoid lying on your back during the dayjust 30 minutes of this posture has been shown to force your fetus to shift to a state that requires less oxygen to survive. These results suggest that lying on your backeven for a short restreduces the oxygen available to your fetus.

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The Link Between Insomnia And Heart Failure

Insomnia can increase the risk of heart disease, stroke, and heart failure. However, whether insomnia causes these conditions or is merely associated with them is unclear.

Insomnia affects 10% to 15% of people in the general population. But nearly 44% of people who have heart problems report frequent insomnia, making this one of the most common symptoms of heart failure.

Theresa Chiechi / Verywell

Sleep Women And Heart Disease

Exercise and eating nutritious foods arent the only things that can help increase heart health sleep is also a factor. The better nights sleep you get, the healthier your heart will be. According to a 2011 study by the American Heart Association, poor sleep quality is linked to an increased risk of high blood pressure, a potential cause of heart disease.

Our study shows for the first time that poor quality sleep puts individuals at significantly increased risk of developing high blood pressure, said Susan Redline, M.D., the studys co-author, in a statement.

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Positive Effects Of Good Sleep

The positive effects of a good sleep are immediately evident when we wake up feeling refreshed and ready to take on the day. Beyond just feeling good, Lundberg explains the solid benefits to our bodies. The positive effect of sleep is not just on your heart health but also on your stress hormones, your immune system, your breathing, and your mental status, she says.

People who get seven to eight hours of sleep have more alertness and better focus. They have less depression and anxiety. Getting a good nights sleep has a positive impact on your metabolism and weight loss benefits.

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How To Keep Heart Failure From Worsening

To keep heart failure from worsening, a patient must make major changes in their life: Theyll need to eat differently, remember to take their medications, keep as active as possible, and reduce stress. Some of these changes might require breaking habits acquired over many years. As a caregiver, you can help your loved one maximize their quality and length of life. Below are some ways to help.

Keep alert for worsening symptoms. Call the doctor immediately if you observe any of the following:

  • Sudden weight gain
  • Increased swelling in the legs or ankles
  • Shortness of breath while at rest
  • A dry, hacking cough or wheezing
  • Dizzy or fainting spells
  • Increased fatigue or feeling unwell all the time
  • Abdominal pain or swelling

Continuous Positive Airway Pressure

Included in the regime of more aggressive therapy towards CHF is CPAP. Although commonly used for OSA, the mechanisms of action in CHF with CSA-CSR differ and may be limited to a subset of patients in whom the cause of CHF is amenable to CPAP . The actions of CPAP can be divided into upper airway pneumatic dilating pulmonary and cardiac .

Table 4

The pulmonary effects of CPAP include increasing lung volume, preventing alveolar collapse and improving oxygen storage and gas transfer and bronchodilation . Assistance with respiratory muscles and abolition of negative intrathoracic pressure has an estimated 40% reduction in the work of breathing , which will minimize the cardiac output required by the respiratory muscles. Thus, CPAP may reduce the cardiac output steal phenomenon by the overworked respiratory muscles during sleep . It is also possible that CPAP induces improved ventilation perfusion matching, reduces acute pulmonary hypertension and thereby prevents intermittent shunting through patent foramen ovale . In addition CPAP may also provide a small but significant rise in dead space, thus increasing CO2 levels. Importantly minute ventilation falls and PaCO2 levels rise in patients with CSA-CSR treated with CPAP therapy.

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Negative Effects Of Sleep Deprivation

The heart is significantly impacted when the body doesnt get enough sleep. As Dr. Gina Lundberg, clinical director of Emory Womens Heart Center, says, People who are sleep deprived have slower metabolism and more difficulty losing weight. They also have the effect of not wanting to exercise or participate in other healthy habits.

Respiratory Sleep Disorders Contributing To Chf

How to sleep better with congestive heart failure

OSA is the main RSD of concern in relation to cause of CHF. Research has provided the greatest understanding of its downstream cardiovascular effects.

Development of systemic hypertension as a precursor to CHF has been attributed to impaired baroreceptor control, impaired release of vasodilator endothelial nitric oxide and a generalized increase in sympathetic activity . Initially patients with OSA lose the usual nocturnal dip in systemic blood pressure and later they develop awaked hypertension and thereafter drug resistant hypertension . Thickening of the vascular media wall in the carotid arteries, whilst sparing the femoral arteries, has raised the possibility of snoring and vibrational damage to the endothelium .

Episodic atrial fibrillation is also common in patients with untreated OSA possibly related to surges in sympathetic activity whilst hypoxia and hypercapnia are present and the atrial walls are stretched. Atrial fibrillation is associated with ~25% reduction in cardiac output.

Coronary artery disease is not only more common in OSA patients, but it may be detected during polysomnography with ST depression on electrocardiograph . In patients with an established myocardial infarction, the relative risk of OSA is equivalent to a history of cigarette smoking .

Table 3

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Can Sleeping Posture Predict Your Personality

That depends on what you consider “personality.” In the 70s and 80s, some researchers claimed they could use sleeping postures to predict if someone were impulsive, feminine, anxious, self-confident–even whether they could be hypnotized.

More recent studies have cast doubt on these theories. The research has been criticized for using “woefully small” numbers of sleepers. Many contradictions have been found between these studies as well.

A more recent attempt to associate personality traits to body positions during sleep came up empty-handed. It showed only a “very weak relationship between sleep positions and personality,” and, using predictions from earlier models, failed to reliably predict the participants’ personality traits.

But on the Other Hand…

Even if earlier studies are unreliable, there may be another way that our sleep postures say something about our personalities. Some sleeping positions are associated with well-rested sleepers. Maybe people who prefer them wake up less crabby and irritable, and are more alert during the day.

Here are some examples, using the Big Five personality traits. A group of 22,000 American and Japanese adults were measured over 10 years. The ones who slept poorly tended to become less conscientious over time. The ones who slept best were the most extroverted and the least neurotic.

So, at the end of the day, the best sleeping position for you may simply be the one that leaves you feeling your best the next day.

How Will Your Doctor Find And Treat Bradycardia

Your doctor will ask about your usual activities and conduct a physical exam.

He or she may use an electrocardiogram to measure the electrical signals in your heart . A wearable, 24-hour monitor can tell your doctor how your heart performs over time.

Once your doctor decides you need treatment, he or she will try to rule out medications or other pre-existing conditions as causes. Sometimes changing medications or similar strategies can solve the problem.

If not, implanting a pacemaker via minimally invasive surgery is the only option to speed up your heart rate, Dr. Baez-Escudero says.

He notes that bradycardia isnt often an emergency, so doctors have time to choose the right treatment.

In general, bradycardia allows time for us to evaluate the condition and rule out if any other condition is responsible, he says. Then, we can adjust medications or take other steps if we need to.

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Best Sleeping Positions For Back Shoulder And Neck Pain

If you have back pain, sleeping on your stomach or back may aggravate your pain. Switch to side sleeping to minimize your risk of back pain.

For further relief, put a pillow between your knees to keep your hips in alignment. If you must sleep on your back, placing a pillow under your knees will take some strain off of your back.

Shoulder, Neck, and Upper Back Pain

Arthritis and other painful conditions along your upper spine can worsen or improve while you sleep. Studies seem to disagree, though, on what positions are ideal.

One large study found that people had less shoulder pain who slept in the starfish positionon their backs, with hands up near their chest or head. But it couldn’t explain if those people had less shoulder pain because of the way they slept, or if they slept that way because they had less pain.

A later study found that people who slept on their backs with their arms at their sidesthe soldier positionactivated their shoulder muscles less, and thus may experience less shoulder pain.

Is Bradycardia Dangerous

Living With Heart Failure

For most young people, highly trained athletes, and people who exercise regularly, a below-60 heart rate is normal and healthy. It is very possible to have a slow heart rate and experience no symptoms.

However, if you have symptoms but ignore them, it can sometimes cause more serious problems.

Consult your doctor if you are experiencing some of these symptoms and you have an associated slow heart rate:

  • Lack of energy.
  • Confusion/memory problems.
  • Heart palpitations or flutters.

If your heart rate drops into the 30s, you might not get enough oxygen to your brain, making fainting, lightheadedness, and shortness of breath possible. Blood can also pool in your heart chambers, causing congestive heart failure.

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Chf Contributing To Rsd

CHF may result in fluid retention and deranged autonomic control. Commonly, patients with CHF complain of dyspnea on exertion, then at rest or during sleep, where it is known as orthopnea or paroxysmal nocturnal dyspnea. Fluid retention results in interstitial edema, pleural effusion and alveolar edema. There may also be pedal edema and at times gut wall edema may lead to malabsorption.

Deranged autonomic control is thought initially to be compensatory for the low cardiac output. This has an effect upon sleep quality in addition to the development of tachyarrhythmias . Poor sleep quality can lead to daytime fatigue, rather than true sleepiness .

Fluid retention can contribute to RSD via several mechanisms. First edema of the upper airway can narrow the lumen , and possibly the surface tension of the upper airway lining thus predisposing to upper airway collapse .

Second, shifting of fluid from lower limbs and abdomen to the thorax can contribute to transient pulmonary edema. This phenomenon is called rostral fluid shift and if concentrated to the lungs cause CSA-CSR, or to the upper airway, OSA. Given that 50% of the oxygen stores are kept within the lungs, a reduction in size or function can exacerbate periodic breathing .

Figure 2Figure 3

Disturbed Sleep Can Trouble The Heart And A Troubled Heart Can Disturb Sleep

Sleep seems to be such a serene way to replenish energy and restore the mind. For your heart, blood vessels, and immune system, though, it’s anything but peaceful. There are periods of calm, to be sure, but they are rudely interrupted by abrupt spikes in blood pressure and heart rate. Blood flow through the heart and brain varies widely during sleep, as do electrical activity in the heart, the elasticity of blood vessels, and the tendency of blood to clot. And all of this activity is just part of a normal night’s sleep.

Researchers are just beginning to reveal the two-way street between sleep and heart disease: Poor sleep can interfere with the heart, and heart disease can disturb sleep.

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