The Link Between Sleep and Heart Health

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There’s more to staying heart-healthy than eating right and exercise – sleep plays an important role in your overall health and wellbeing, too. Jolene Fransen, respiratory therapist, UnityPoint Health, explains how poor sleep can affect your heart and the link between sleeping disorders and other heart problems.

Can lack of sleep cause heart problems?

“There’s a strong connection between sleep and cardiovascular health,” Fransen says.

Studies have shown short sleep duration, or poor sleep quality, is associated with high blood pressure, elevated cholesterol and atherosclerosis (thickening, hardening and loss of elasticity of the walls of the arteries).

People with common sleep disorders, like obstructive sleep apnea (OSA), are far more likely to experiencing the following as well:

  • Heart arrhythmias
  • Plaque buildup
  • Heart failure
  • Coronary artery disease
  • High blood pressure

According to a study from the National Institute of Health, people who sleep less than six hours per night are 66% more likely to have hypertension than those who get seven to eight hours per night. As a baseline, the American Heart Association recommends seven to nine hours of sleep.

How does sleep impact your physical and mental health?

Poor sleep is also linked to these health conditions:

  • Type 2 diabetes: Studies show not getting enough sleep significantly increases the risk of developing Type 2 diabetes. In addition, losing as little as two hours of sleep per day may lead to increased insulin resistance and decreased glucose tolerance. High blood sugar associated with diabetes can also increase cholesterol, blood pressure and triglycerides, which ultimately causes damage to nerves and blood vessels. As a result, people with Type 2 diabetes are twice as likely to suffer a heart attack or stroke.
  • Obesity: Not getting enough sleep may affect a part of the brain that controls hunger and can lead to unhealthy weight gain. This is especially important for children and teens, because they require more sleep than adults. “If you’re tired, you’re less active,” Fransen points out. “Too little sleep also affects the hormones ghrelin and leptin, which influence appetite and metabolism; so even if you eat right and exercise, you can gain weight if you have too little sleep or have an undiagnosed, untreated sleep disorder,” she adds.
  • Mental health: Poor sleep can impact your mood, which affects work and home life and can lead to, or worsen, anxiety and depression. These conditions are both risk factors for heart disease.

Can heart problems make you sleep a lot?

As your heart works overtime, it can cause tiredness, shortness of breath and feeling worn out. These symptoms are all signs of fatigue, one of the most common symptoms of congestive heart failure.

Can lack of sleep cause heart palpitations?

Poor sleep, including abrupt awakenings, can cause a sharp rise in heart rate. Research has found people with sleeping problems are more likely to complain of an irregular heartbeat. For these reasons, lack of sleep may be tied to heart palpitations.

The link between sleep disorders and heart disease

Sleep apnea: Obstructive sleep apnea (OSA) can cause heart problems. It’s a breathing disorder linked to heart disease, obesity, diabetes, stroke, arrhythmia, and high blood pressure. There’s also evidence that sleep apnea can cause left ventricular diastolic dysfunction, which increases the risk of heart failure. Sleep apnea affects the heart by interrupting breathing during sleep when the airway is blocked. This reduces the amount of oxygen in the blood, which causes your heart to work harder to increase oxygen levels.

Insomnia: This sleep disorder involves trouble falling asleep, staying asleep or both. Insomnia is linked to heart disease and high blood pressure. Over time, poor sleep can also lead to unhealthy habits that can affect your heart, including high stress levels, less motivation to be physically active and unhealthy food choices.

Can heart damage from sleep apnea be reversed?

Treating sleep apnea can help prevent and/or improve heart problems. The most common way of treating obstructive sleep apnea is with a mechanical device known as continuous positive airway pressure (CPAP).

People who use a CPAP regularly show improvements in physical functioning, mood, sleepiness, pain and miss fewer workdays. Sleep apnea treatment, combined with heart failure treatment, may reverse a person's existing heart damage by improving cardiac function.

In one study, sleep apnea patients were treated for an average of six months with a CPAP and then given a follow-up echocardiogram. The scan revealed much of the heart damage had been reversed.

What's the best sleeping position for your heart?

A person’s sleeping position isn’t considered to be a risk factor for heart disease or other cardiovascular problems. While studies show people with heart failure often avoid sleeping on their left side, there’s no evidence this sleeping position causes heart problems.

Which side is better to sleep on for your heart?

Determining if it’s better to sleep on your right or left side depends on your health conditions. The left side may provide more benefits for people who are pregnant or experience gastroesophageal reflux disease (GERD).

People with heart failure might experience discomfort on their left side and prefer to sleep on their right side. Echocardiograms of people with heart failure show that left side sleeping impacts the way the heart functions, potentially causing discomfort.

People with heart failure should also avoid sleeping on their backs, since it puts pressure on the lungs and can contribute to sleep apnea symptoms. More than half of people experiencing heart failure also have a type of sleep apnea.

How to avoid a heart attack while sleeping

It's possible to have a heart attack while sleeping. Lifestyle changes are key to protecting your heart health, such as:

  • Being physically active
  • Having a healthy diet
  • Limiting alcohol intake or not drinking at all
  • Losing weight or maintaining a healthy weight
  • Getting enough sleep (research shows 7-9 hours a night is best)
  • Maintaining healthy cholesterol levels
  • Quitting smoking
  • Reducing stress
  • Treating and managing conditions that affect heart health, such as diabetes and obstructive sleep apnea

Sleep tips for people with heart problems

While there’s no one solution, certain things can help people with heart problems get better sleep.

  • Develop strategies for relaxation: If heart concerns spur anxiety, they can keep your mind racing when you just want to sleep. Techniques like deep breathing, yoga, light stretching, mindfulness and meditation are beneficial approaches for people struggling with how to sleep with heart disease or other heart problems that cause chest pain.
  • Plan a consistent sleep schedule: Going to bed and waking up at the same time every day is widely considered to be one of the best ways to encourage healthy and stable sleep.
  • Design an accommodating bedroom: Create your sleep environment that meets your needs with a comfortable mattress and pillow, a pleasant temperature and as much quiet and darkness as possible.
  • Avoid stimulants before sleep: Alcohol and caffeine can both interfere with sleep and should be avoided before bed. Excessive use of electronic devices, including your cell phone, can also throw off your sleep patterns, which is why experts recommend not using these devices an hour or more before you go to sleep.

If you’re struggling with sleep, have a heart condition or both, talk to your doctor about a treatment plan to help you feel better and well-rested.