If you’re living with heart disease, you may also experience sleeping problems like insomnia. Insomnia — difficulty falling or staying asleep — is actually quite common in people with different types of heart disease. While a number of factors can influence your ability to get a good night’s sleep, heart disease symptoms and treatments may make it more difficult to get the rest you need every night.

Members of MyHeartDiseaseTeam, the online social support group for people with heart disease, discuss living with both heart disease and insomnia. One member said, “My insomnia keeps me from sleeping until about 3:30 a.m. every night.” Another commented, “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.”

Don’t hesitate to talk to your doctor or cardiologist about any sleeping issues you experience. Insomnia can be managed by adopting healthy habits — and in severe cases, through medication and consultation with a sleep specialist. If you have heart disease, getting quality sleep is particularly important, as poor sleep can worsen your condition.

Read on to learn more about insomnia, its connection to heart disease, and tips for getting a better night’s rest.

What Is Insomnia?

Insomnia is a sleeping disorder in which one has trouble falling asleep, staying 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.

Insomnia is the most common sleep disorder in the U.S. According to the Centers for Disease Control and Prevention (CDC), as many as 1 in 2 adults have short-term insomnia at some point in their lives, and 1 in 10 experience long-term insomnia.

The average adult needs seven to eight hours of sleep each night. Getting insufficient sleep due to insomnia and sleep deprivation can contribute to various health issues. It can increase a person’s risk for obesity and type 2 diabetes — or worsen those conditions, which are risk factors for heart disease. If severe enough, insufficient sleep can even cause thought disorders, concentration difficulties, and cardiac disturbances.

Insomnia can be managed by practicing good sleep habits. You should speak with your health care provider if sleeping problems start to affect your quality of life.

How Can Heart Disease Cause Insomnia?

Insomnia is common in people living with cardiovascular conditions like heart disease. A 2021 research study found that 45 percent of coronary heart disease outpatients experienced insomnia. Furthermore, insomnia has been found to increase hypertension (high blood pressure), coronary heart disease, and heart failure.

“I’m still feeling tired. Haven’t been able to sleep much,” wrote a member of MyHeartDiseaseTeam. Another responded saying, “I have been struggling with sleep lately as well.”

There are several reasons why people living with heart disease might experience insomnia.

Heart Disease Symptoms

Heart disease symptoms like chest pain and discomfort, trouble breathing, and gastrointestinal issues such as heartburn may make it difficult to find a comfortable sleeping position and fall asleep. 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, palpitations, or paroxysmal nocturnal dyspnea (sudden shortness of breath during sleep).

People with heart disease may also experience stress about their condition and be fearful of having a cardiac event, like a heart attack. Feeling worried can make relaxing and falling asleep difficult. Worry may also cause you to wake up from a sound sleep. Occasionally some of the medications for controlling heart-rhythm disturbances may cause bad dreams or nightmares

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 research study on people with heart disease found that anxiety was their most common cause of insomnia.

Heart Disease Treatments

Treatments for heart disease like medication and surgery may contribute to insomnia. Various types of drugs may affect sleep:

• Beta-blockers, such as carvedilol (sold as Coreg), 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 (e.g., lisinopril, sold as Zestril) and angiotensin-receptor blockers (such as valsartan, sold as Diovan), have been associated with insomnia.
• Several medications used to control heart rhythms have been associated with sleep disorders, especially at higher dosages. These include flecainide (Tambocor) and propafenone (Rythmol).
• Statins for high cholesterol, such as atorvastatin (Lipitor), have — in rare instances — been associated with muscle discomfort that makes falling asleep difficult.

Never stop taking your heart disease medications without first talking to your doctor. Discontinuing these medications without medical guidance could cause serious harm.

Other heart disease treatments like surgeries may impact your sleep. These include:

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

Recovering from these types of surgery can take several weeks. Chest pain and other symptoms after surgery may impact your ability to lie comfortably and fall asleep. They also may cause short-term insomnia while you are healing.

9 Tips for Improving Sleep With Heart Disease

While insomnia can cause your body additional stress and complicate the management of heart disease or other health conditions, there are practical ways to improve your sleep.

1. Maintain a Regular Sleep Schedule

Try to create a sleep schedule wherein you’re going to sleep and waking up at the same times every day. Doing so can help your body fall into a routine, which can help improve insomnia.

Your sleep schedule can include a pre-bedtime ritual, which you can tailor to your interests. Some ideas include reading, taking a bath, listening to music, or doing other calming activities.

2. Avoid or Reduce Daytime Naps

Try not to take naps during the daytime, as they can make falling asleep at night more difficult. MyHeartDiseaseTeam members have attested to this, saying that napping tends to make them sleep less at night. If you do need to take daytime naps, try limiting them to one hour.

3. Maintain a Comfortable Sleep Environment

Create a bedroom environment that is conducive to quality sleep. Make your bedroom dark, quiet, and cool. Avoid bright lights and screens close to bedtime. Taking these measures can help ensure a better sleep quality.

4. Get Daily Physical Activity

Regular exercise or physical activity can help you sleep well at night. Working your muscles and keeping busy can tire out your body and mind, making sleep come more easily. According to Sleep Foundation, there’s no universal time of day that people most benefit from exercising. Moderate-intensity exercise in the evening doesn’t impair sleep for most people, so long as they finish within 90 minutes of bedtime.

Some moderate-intensity exercises for people with heart disease include walking, water aerobics, or riding a bike at a low speed. “Did one hour at the gym and got a good night’s sleep,” said a MyHeartDiseaseTeam member.

5. Use Medications When Necessary

Some members of MyHeartDiseaseTeam have had success using medications like Tylenol PM, antihistamines, or melatonin to help them fall asleep. Always consult your doctor before trying any over-the-counter medications for sleep. Some of these medications have a risk of 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 substances like caffeine, nicotine, and alcohol before bed to help you get a deeper sleep. Caffeine late in the day will keep your brain stimulated and make it harder for you to fall asleep. Although a little bit of alcohol may make you feel sleepy, drinking it can also make staying asleep and getting rest difficult.

7. Ask Your Doctor About Related Sleep Problems

Tell your doctor if you’re having trouble sleeping. They will work with you to determine if you have long-term insomnia or another sleep disorder like obstructive sleep apnea. A member of MyHeartDiseaseTeam brought up their sleeping difficulties with their doctor and found out they had both sleep apnea and insomnia.

8. Keep a Sleep Diary

Some MyHeartDiseaseTeam members have found it helpful to track their sleep patterns with a sleep diary. This can also be a useful resource to show to your doctor or specialist to highlight problem areas, which can help them better understand how they can assist you in getting enough sleep.

9. Find Ways to Relax Before Bedtime

Finding ways to relax the mind and body in the evening are important for setting yourself up for a good night’s sleep. Researchers have found that practicing meditation can help improve sleep quality and insomnia.

Some people benefit from using white noise to block out sounds that would ordinarily interrupt sleep patterns. Some stores sell devices designed to produce different types of white noise. You may also be able to find white noise audio and video tracks online or through apps.

Relaxing music may also help you feel asleep. “I have a playlist on my phone and when I can’t sleep, I listen to music until I can relax enough to fall asleep,” said a member of MyHeartDiseaseTeam.

Drinking herbal tea in the afternoon or evening may also help relaxation. According to Sleep Foundation, these six herbs that have been shown to improve sleep and help with relaxation:

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

Being able to calm yourself before you go to bed may be the difference between lying awake 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, more than 52,000 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.