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Sleep Hygiene with Heart Failure

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“Regardless of sleep position, if you want to get a better night’s sleep with heart failure or any chronic condition, the main focus should be on good sleep hygiene…”

Heart failure (HF)? Sleep Hygiene? Yikes. I don’t mind saying that I feel a little old when I write those terms when I am writing a sort of “how to” blog post. But here I am. I am a long-term cancer survivor struggling with chemotherapy-induced cardiomyopathy.  I focus on sleep hygiene to get a good night’s sleep.

I work at my sleep aka sleep hygiene. Gone are the days when I could sleep 10-12 hours at a time without waking up. The sleep hygiene techniques below that work best for me are:

  • Consistent sleep schedule- I am in bed by 9:00 pm and awake by 5:00 am- Monday-Friday
  • Sleep environment- dark, cool in the winter, heavy blankets, quiet, etc.
  • I drink coffee but only with breakfast-
  • Moderate exercise daily (I have heart issues so…)
  • No naps- one nap and I awake for at least 30 mins. after I pee at 1:00-ish- 

What is sleep hygiene?

Sleep hygiene refers to a set of practices and habits that promote healthy and restful sleep. These practices are aimed at optimizing the quality and duration of sleep, as well as improving overall sleep patterns. Some common components of good sleep hygiene include:

  1. Consistent sleep schedule: Going to bed and waking up at the same time every day, even on weekends, helps regulate your body’s internal clock.
  2. Creating a conducive sleep environment: This involves keeping your bedroom dark, quiet, and cool, and using a comfortable mattress and pillows to promote relaxation.
  3. Limiting exposure to screens: Avoiding electronic devices such as smartphones, tablets, computers, and TVs before bedtime, as the blue light emitted by these screens can interfere with your ability to fall asleep.
  4. Avoiding stimulants: Limiting consumption of caffeine, nicotine, and alcohol, especially in the hours leading up to bedtime, as these substances can disrupt sleep patterns.
  5. Regular exercise: Engaging in regular physical activity can help improve sleep quality, but it’s best to avoid vigorous exercise close to bedtime as it may make it harder to fall asleep.
  6. Establishing a bedtime routine: Engaging in relaxing activities such as reading, taking a warm bath, or practicing relaxation techniques like deep breathing before bed can signal to your body that it’s time to wind down.
  7. Limiting naps: While short naps can be beneficial, especially for those who are sleep deprived, it’s best to avoid long or late-afternoon naps, as they can interfere with nighttime sleep.
  8. Managing stress: Practicing stress-reduction techniques such as meditation, mindfulness, or journaling can help quiet the mind and promote relaxation before bedtime.

I think my sleep hygiene is an important tool for managing my heart health. I have never taken conventional heart meds such as metoprolol, ACE inhibitors, etc.

I do the above as well as eat nutritionally and take heart healthy supplements such as CoQ10, Omega-3 fatty acids, etc.

If you would like to learn more about evidence-based non-conventional heart therapies send me an email- David.PeopleBeatingCancer@gmail.com

Hang in there,

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

4 Sleep Problems Related to Heart Failure and 5 Ways to Manage Them

Heart failure can put a strain on your sleep health. Here’s what you need to know to rest easy.

Heart failure may cause you to feel weak and fatigued during the day. But did you know that daytime tiredness might be in part the result of sleep problems exacerbated by or occurring in conjunction with heart failure?

Known culprits include sleep apnea, orthopnea, and periodic limb movement disorder…

1. Sleep Apnea

Sleep apnea is present in up to 70 percent of heart failure patients, says Dr. Khayat…

2. Orthopnea

Many people with heart failure also experience orthopnea, a feeling of breathlessness while lying down, or paroxysmal nocturnal dyspnea, shortness of breath that wakes them up after one or two hours of sleep, says Dr. Markham. “These are related to ventricular pressure and volume overload,” he says. Both conditions improve upon sitting or standing.

3. Periodic limb movement disorder (PLMD)

In PLMD, increased nerve traffic in the legs and arms causes them to twitch involuntarily while you sleep, which may awaken you, says Khayat..

4. Insomnia

Insomnia, which often goes hand in hand with chronic conditions, may also be to blame. “If you have a chronic condition, often there’s a degree of concern or anxiety. Sometimes there’s concern over hospitalizations, medication schedules. Or there’s decreased activity. All of these things affect your ability to maintain sleep,” says Khayat…

Better Sleep Positioning

According to Markham, most people with heart failure figure out their best sleep position through trial and error. Here are 5 things to try if you have heart failure and are struggling to get a good night’s sleep.

1. Get screened for sleep apnea. In cases of OSA, a continuous positive airway pressure (CPAP) machine or other treatment may be prescribed. “In some of the patients who have this (CPAP) treatment, we see improvement of the ejection fraction, which is the pumping function of the heart, and there’s even some data to support that arrhythmias may be decreased by this intervention as well,” says Markham.

2. Sleep on your side. If you have sleep apnea, side sleeping can be beneficial for those who don’t tolerate CPAP, says Khayat. “In heart failure patients, lateral sleep positions on the side, left or right, can often decrease sleep apnea.”

A bit of controversy surrounds whether the left or right side is best, says Khayat. If you have an implanted defibrillator, sleep on the opposite side. Most defibrillators are implanted on the left side, so sleeping on the right side may feel more comfortable.

“If they don’t have an implant, sometimes the left side is more comfortable because, just like in pregnancy, it relieves the pressure off the IVC, the body’s largest vein, which is on the right,” says Khayat.

3. Elevate the head of your bed. “Some people need more pillows or need to elevate the head of the bed just in order to sleep,” says Markham. Sleeping on an incline can reduce the anatomical and volume overload of lung congestion, including orthopnea and paroxysmal nocturnal dyspnea.

Medicare Part B covers the rental or purchase of adjustable hospital beds provided your doctor prescribes the equipment as medically necessary. Your 20 percent copay and deductible apply. Extra pillows also work, but your entire back, along with your head, needs to be elevated.

4. Elevate your feet. If you have edema in your legs or feet, you may find it comfortable to put pillows under your legs to reduce the swelling, says Markham. Wearing compression socks at night may also help.

5. Avoid sleeping flat on your back, unless you have a CPAP machine. “Once the patient gets on CPAP, they can sleep in any position they want because the machine prevents sleep apnea,” says Khayat.

Regardless of sleep position, if you want to get a better night’s sleep with heart failure or any chronic condition, the main focus should be on good sleep hygiene, says Khayat.

He recommends:

  • maintaining a regular sleep and wake time,
  • avoiding alcohol and caffeine before bedtime — both of which can disrupt sleep —
  • and staying off electronic devices several hours prior to sleep, which can make it more difficult to fall asleep.

If your doctor okays it, Khayat also suggests those with heart failure get daily brisk exercise. “A cardiovascular routine that lasts 20 or 30 minutes about four to five hours before bedtime helps in improving their sleep consolidation, their ability to generate sleep and to stay asleep,” he says.”


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