Heart Failure and a Good Night’s Sleep

Yale Health and Medicine Podcast

Five million Americans live with heart failure and a surprising number of those live with a serious sleep problem. There is a large body of evidence showing that sleep apnea, problems with breathing during sleep, where you have pauses in your breathing contribute to high blood pressure which can contribute to other cardiovascular consequences including heart failure.

In addition, sleep apnea can have major consequences to a person’s quality of life. We know that insomnia and general problems breathing during sleep can cause changes in cognitive function, and memory, and can also result in fatigue. Heart failure is associated with a lot of fatigue, problems going about one’s daily activity, and shortness of breath. In fact more and more research attributes this to sleep problems and if we can improve sleep we can impact some of these problems. There is research that shows this can shorten one’s life.

Sleep deprivation can lead to higher levels of mortality.  We are not sure what the exact  biological mediators are, but there is a growing body of evidence that does point to sleep disturbances. Apnea, specifically.  50% of heart patients have significant sleep apnea. Insomnia is another contributing factor and we think the link there is with depression. Pain and shortness of breath can contribute to problems with sleeping. People with cardiac problems can have difficulty sleeping flat on their back because breathing becomes more difficult due to fluid congestion. Poor sleep habits such as not keeping regular sleep hours, trying to sleep in a noisy environment also contribute to poor sleep hygiene. Then there is the issue of not getting enough sleep. We seem resigned to it. We drink a lot of coffee and suck it up.

Studies conducted by the National Institute of Health (NIH) has determined that short sleep cycles can contribute to a shortening of life. We are not sure why that happens, but the feeling is that this contributes to diabetes and hypertension. Studies have even looked at shift work and its contribution to cancer. So the problem is not benign. We need to take sleep seriously just like we have taken diet and exercise seriously to provide a healthy life style. Sleep therefore should be part of routine health evaluation.

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Sleep Disorders and OSB.