Can Poor Sleep Cause Heart Problems?

There’s more to staying heart-healthy than eating right and exercise. Sleep plays an important role, too. Jolene Fransen, respiratory therapist, UnityPoint Health, explains how poor sleep can lead to heart disease.

Can Lack of Sleep Cause Heart Problems?

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

Studies show short sleep duration or poor sleep quality are associated with high blood pressure (hypertension), elevated cholesterol and a hardening and loss of elasticity in the artery walls (atherosclerosis).

People with common sleep disorders, specifically obstructive sleep apnea (OSA), are far more likely to experience chronic cardiovascular disease, because the body doesn’t get the rest it needs to lower your heart rate and blood pressure naturally. Heart conditions that can result include:

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

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

Can Lack of Sleep Cause Heart Palpitations? 

Yes, people who suffer from sleep disorders are more likely to experience an irregular heartbeat, indicating a lack of sleep may be tied to heart palpitations.

Can Lack of Sleep Cause an Abnormal Heartbeat?

Yes. With sleep apnea, abrupt awakenings caused by gasping for air can generate a sharp rise in heart rate and adrenaline. Research shows people who have chronic sleep issues are more likely to experience an abnormal heartbeat, such as atrial fibrillation. In some cases, sleep apnea also causes a slow heart rate (bradycardia) during sleep, followed by sudden spikes that strain the heart muscle.

How Does Sleep Impact Your Physical and Mental Health?

Poor sleep is also linked to these health conditions:

• Mental health disorders: Poor sleep impacts 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. 
• Obesity: Not getting enough sleep may affect a part of the brain that controls hunger and cause 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 says. “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.
• 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 damages the nerves and blood vessels. As a result, people with type 2 diabetes are twice as likely to suffer a heart attack or stroke.

Can Heart Problems Make You Sleep Alot?

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

The Link Between Sleep Disorders and Heart Disease

If you’re not getting enough quality rest, it can take a serious toll on your cardiovascular health in several ways:

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 affect your heart, including high stress levels, less motivation to be physically active and unhealthy food choices.

Sleep apnea: Obstructive 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.

Sleep apnea is linked to heart disease, obesity, diabetes, stroke, arrhythmia and high blood pressure. There’s also evidence it causes left ventricular diastolic dysfunction, which increases the risk of heart failure.

Can Heart Damage from Sleep Apnea be Reversed?

Treating obstructive sleep apnea with a mechanical device, known as continuous positive airway pressure (CPAP), can help prevent or improve heart problems.

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 with a CPAP machine for about six months and then given a follow-up echocardiogram. The scan showed much of the heart damage had reversed.

What's the Best Sleeping Position for Your Heart?

There’s limited evidence linking your sleeping position to your heart health. While studies show people with heart failure often avoid sleeping on their left side, it doesn’t mean this sleeping position puts you at higher risk for heart problems.

Which Side to Sleep on for Your Heart

The left side is better for people who are pregnant or those with gastroesophageal reflux disease (GERD).

Many people with heart failure — especially those with an enlarged heart — prefer sleeping on their right side to avoid discomfort. It’s not clear why, but right-side sleeping may reduce pressure on the lungs and the sensation of the heart beating against the chest wall.

Patients should avoid sleeping on their backs, as this can worsen breathing and contribute to sleep apnea, which affects more than half of those with heart failure.

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.

• Avoid stimulants before sleep: Don’t drink alcohol or caffeine before bed. Stop using electronic devices, including phones, at least one hour before sleep to prevent disrupting your natural patterns.
• Design an accommodating bedroom: Create a sleep environment with a comfortable mattress and pillow, a pleasant temperature and as much quiet and darkness as possible.
• Develop strategies for relaxation: If heart concerns spur anxiety, try deep breathing, yoga, light stretching, mindfulness and meditation before bed.
• Plan a consistent sleep schedule: Going to bed and waking up at the same time every day is one of the best ways to get quality sleep.

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