If you’re living with heart disease, you may also experience sleeping problems, particularly insomnia. Insomnia — difficulty falling or staying asleep — is common in people with different types of heart disease. While a number of factors can affect your ability to get a good night’s sleep, symptoms of heart disease or side effects from treatments can make restful sleep even harder to come by.

As one member shared, “My insomnia keeps me from sleeping until about 3:30 a.m. every night.” Another said, “I’ve been dealing with insomnia since November of last year and it isn’t fun at all. I think it feels worse than my heart failure right now.”

In this article, we’ll explore what insomnia is, how it’s connected to heart disease, and tips for getting a better night’s rest.

What Is Insomnia?

Insomnia is a sleep disorder that makes it hard to fall asleep, stay asleep, or both. Insomnia can lead to fatigue, daytime sleepiness, and irritability or mood changes. Insomnia can be short term (lasting several days or weeks) or long term (lasting longer than a month).

According to the American Academy of Sleep Medicine, about 12 percent of Americans live with chronic insomnia, defined as having sleep difficulties at least three nights a week for three months or more.

Adults typically need seven to eight hours of sleep each night. Lack of sleep due to insomnia and sleep deprivation can contribute to several health issues. It can increase your risk for obesity and type 2 diabetes, which are risk factors for heart disease — or worsen those conditions. When sleep deprivation becomes severe, it can even cause thought disorders, concentration difficulties, and disturbances in heart rhythm or function.

Is Insomnia a Symptom of Heart Problems?

Insomnia is common among people living with cardiovascular conditions such as heart disease. A 2021 research study found that 45 percent of outpatients with coronary heart disease experienced insomnia.

You may have wondered, “Does insomnia cause high blood pressure?” Research suggests it can. Insomnia has been linked to increased hypertension (high blood pressure), coronary heart disease (narrowing of the blood vessels that supply heart), and heart failure (when the heart can’t pump effectively).

Insomnia has been found to increase high blood pressure, coronary heart disease, and heart failure.

There are several reasons why people with heart disease may struggle with insomnia.

Heart Disease Symptoms

Heart disease symptoms such as chest pain and discomfort, trouble breathing, and gastrointestinal issues such as heartburn can make it harder to find a comfortable sleeping position. Insomnia and heart palpitations can also interfere with sleep, especially when lying down.

Conditions like orthopnea (shortness of breath) can sometimes worsen when you lie down, making falling or staying asleep difficult. Some people may actually be awakened by chest pain or paroxysmal nocturnal dyspnea (sudden shortness of breath during sleep due to heart weakness). Orthopnea and paroxysmal nocturnal dyspnea affect people with heart failure.

Living with heart disease can be stressful. Concerns about one’s health or fear of a cardiac event, such as a heart attack, can make it hard to relax and fall asleep. Stress and worry may also cause you to wake up from a sound sleep. Some medications for controlling heart-rhythm disturbances may cause bad dreams or nightmares sometimes.

Mental health problems such as anxiety and depression are more common in people with chronic conditions. Anxiety, depression, and some medications used to treat them can also cause sleep problems. A study of people with heart disease found that anxiety was the most common cause of insomnia.

What Sleep Position Is Best for Your Heart?

If you have heart disease, sleeping on your back may make it harder to breathe and could lead to sleep disturbances like waking up at night. Many people find that sleeping on their side — especially the right side — is more comfortable and helps them sleep better. Finding a position that supports your breathing can improve sleep hygiene and reduce the strain that lack of sleep puts on your heart.

Sleeping on your side — especially the right side — may help you breathe easier and sleep better if you have heart disease.

Heart Disease Treatments

Certain treatments for heart disease — including medications and surgery — may contribute to insomnia:

• Beta-blockers decrease your body’s production of melatonin, a hormone that helps regulate sleep. This can cause insomnia as well as nightmares.
• Treatments for high blood pressure, including ACE inhibitors, have been associated with insomnia.
• Several medications used to control heart rhythms have been associated with sleep disorders, especially at higher dosages.
• Statins for high cholesterol have — in rare cases — been linked to muscle discomfort that makes it harder to fall asleep.

Never stop taking your heart disease medications without talking to your doctor first. Stopping these medications suddenly without medical guidance can be dangerous and cause serious complications.

Other heart disease treatments such as surgeries may also impact your sleep. These include:

• Coronary artery bypass graft surgery
• Pacemaker implantation surgery
• Heart valve surgery
• Heart transplant

Recovering from these types of surgery can take several weeks. During recovery, chest pain, discomfort, or general fatigue can make lying down and falling asleep difficult. These symptoms may also cause short-term insomnia that usually improves as you heal.

9 Tips for Improving Sleep With Heart Disease

Even though insomnia can add stress to your body and complicate the management of heart disease or other health conditions, there are steps you can take to improve your sleep.

1. Maintain a Regular Sleep Schedule

Try to create a sleep schedule where you go to sleep and wake up at the same time every day, even on weekends. A consistent routine helps your body adjust to a natural rhythm, which can help improve insomnia.

Your sleep schedule can include a calming bedtime ritual to wind down. This could include reading, taking a bath, gentle stretching, or listening to soothing music.

2. Avoid or Limit Daytime Naps

Try not to nap too much during the daytime, as this can make it harder to fall asleep at night. Many MyHeartDiseaseTeam members have confirmed this, saying that napping tends to make them sleep less at night. If you need a nap, keep it under one hour, and avoid napping late in the day.

3. Maintain a Comfortable Sleep Environment

Make your bedroom a place that supports quality sleep. Keep the space dark, quiet, and cool. Avoid bright lights and screens at least an hour before bedtime. A calm, low-stimulation environment can help ensure better sleep quality.

4. Get Daily Physical Activity

Regular exercise or physical activity can help you sleep better at night. Staying active during the day can help tire both your body and mind, making it easier to fall asleep at night. According to Sleep Foundation, there’s no single “best” time of day to exercise for sleep benefits.

For most people, moderate-intensity exercise in the evening doesn’t interfere with sleep as long as you finish at least 90 minutes before bedtime.

5. Use Medications When Necessary

Some members of MyHeartDiseaseTeam have found relief from insomnia with medications like Tylenol PM, antihistamines, or melatonin. Always talk to your doctor before trying any over-the-counter sleep aids. Some of these medications may cause side effects or harmful interactions with your prescription heart disease medications.

6. Avoid Substances That Can Keep You Awake or Disrupt Sleep

Limit or avoid caffeine, nicotine, and alcohol in the hours leading up to bedtime. Caffeine late in the day can keep your brain alert and make it harder for you to fall asleep. Although a little bit of alcohol may make you feel sleepy, it can also lead to lighter, disrupted sleep during the night.

7. Ask Your Doctor About Related Sleep Problems

If you’re struggling with persistent sleep issues, don’t hesitate to talk to your doctor or cardiologist. They will work with you to determine whether you have long-term insomnia or another sleep disorder such as obstructive sleep apnea. Insomnia can be managed by adopting healthy habits — and in severe cases, through medication and consultation with a sleep specialist. If you’re living with heart disease, getting quality sleep is especially important, as poor sleep can worsen your condition.

8. Keep a Sleep Diary

Some members of MyHeartDiseaseTeam have found it helpful to track their sleep patterns with a sleep diary. Recording when you fall asleep, how often you wake up, and how rested you feel in the morning can help your doctor better understand how to assist you in getting enough sleep.

9. Find Ways To Relax Before Bedtime

Finding ways to relax the mind and body before bed can set you up for a good night’s sleep. Research has found that practicing meditation can help improve sleep quality and insomnia.

Some people benefit from white noise to block out sounds that might otherwise disrupt sleep patterns. White noise machines, apps, or online recordings can provide consistent, soothing sound that promotes relaxation.

Drinking herbal tea in the afternoon or evening may also support rest. According to Sleep Foundation, these six herbs may help promote relaxation and better sleep:

• Chamomile
• Lavender
• Lemon balm
• Magnolia bark
• Passionflower
• Valerian root

Establishing a calming evening routine can make all the difference between tossing and turning and getting a good night’s sleep.

Talk With Others Who Understand

MyHeartDiseaseTeam is the social network for people with heart disease and their loved ones. On MyHeartDiseaseTeam, members come together to ask questions, give advice, and share their stories with others who understand life with heart disease.

Are you living with heart disease and insomnia? What are your tips for managing it? Share your experience in the comments below, or start a conversation by posting on your Activities page.