Heart Failure: Dealing with Sleep Problems
If you have heart failure and you’re not sleeping well, there are many possible reasons. Many people with heart failure also have sleep apnea. This is a condition that causes snoring and brief periods of not breathing. Age, certain medicines, and not getting enough exercise can also affect sleep. Be sure to tell your healthcare provider if you’re having sleep problems.
Tips for sleeping better
If shortness of breath keeps you awake, your healthcare team needs to know. Tell them if you can’t lie flat or need to sleep propped up on pillows. Or tell them if you can only sleep sitting up in a chair or recliner. If nighttime shortness of breath gets worse, bring this to the team’s attention. You may be accumulating fluid and need more diuretic medicine. If you have other sleep problems not related to shortness of breath, these tips may help:
Do deep breathing in bed. This will relax you and help you fall asleep.
Don’t drink caffeine any later than noon.
Try to go to sleep and wake up around the same time every day. This helps your body set up a sleep cycle.
Avoid napping. This can affect your sleep cycle.
Pull window shades down. If the room isn’t dark enough, get blackout shades.
Keep pets out of the bedroom if they bother you at night.
Wear comfortable, loose pajamas. Pajamas that fit tightly may make you feel like it's harder to breathe.
If you take medicines at bedtime, talk with your healthcare provider about changing this. Certain medicines may be keeping you awake. Or they may cause you to wake up often to use the bathroom.
Talk with your healthcare provider about taking over-the-counter sleep aids. Some OTC medicines can interact with your prescribed medicines. Or they may have salts in them that cause you to retain fluids.
Do you have sleep apnea?
You may not know you have sleep apnea unless someone notices that you have irregular breathing, gasping at night, or snoring while you sleep. You should get checked for this condition. If you have it, treatment can improve your health. Treatment can also ease the stress on your heart and body.
Your healthcare provider may prescribe a CPAP (continuous positive airway pressure) or BiPap (bilevel positive airway pressure) device. The machine sends a gentle flow of air through a nasal mask while you sleep. This air goes through your nose and into your lungs, keeping airways open.
Tips for using CPAP and BiPap
If your mask doesn’t fit or feel right, talk with your healthcare provider or the vendor about adjusting it or trying a new one.
If you have allergies or other problems that block your nose, get those treated. These devices work best if your nose is clear.
If the device doesn’t feel good or work well at first, don’t stop using it. Ask your provider or someone from your medical equipment company for ways to help make it work for you.
Newer devices are small, lightweight, and portable. You should take your machine with you when you travel or are not sleeping at home. Some devices have chargeable batteries. They can be taken camping or when sleeping outdoors.
Do not use tap water to fill the water chamber for humidity. Deposits in tap water can build up and affect the machine and your breathing. The product makers usually recommend that you use sterile water or distilled water.
Ask your healthcare provider if you need oxygen along with your CPAP or BiPAP machine. Some people with heart failure need both.
The equipment wears out with time. Make sure your equipment is tested. Get new equipment as often as your healthcare provider recommends.
March 21, 2017
Sleep disordered breathing in heart failure. UpToDate.
Fetterman, Anne, RN, BSN,Kang, Steven, MD