What is the best way to sleep if you have heart problems?
- Find out the best sleep positions for heart health
As anyone who has experienced cardiac issues will know, if you are told there is a health issue concerning your heart then anxiety and panic are frequent responses. According to the center for disease control, every 40 seconds someone in the USA will have a heart attack, which adds up to over 800,000 Americans a year. Of course, a heart attack is just one of a list of symptoms that indicate that all is not well with our hearts. Many people are oblivious to their sub-functioning heart whereas others are identified through symptoms and scans and manage their condition. For some this requires surgery, for others it does not. Whether you have experienced a cardiac arrest, open heart surgery or live with a life long cardiac condition, sleep is a vital component of your recovery. When we sleep the body not only has a chance to repair itself but enables our minds to rest so that we are physically and mentally stronger to deal with he challenges the following day may present. Therefore, knowing the best way to sleep if you have heart problems and adopting the best sleep positions for heart health is vital to ensure the restorative rest that cardiac patients require.
What is the best position to sleep in for your heart?
If you have recently been diagnosed with heart disease or have had a heart attack, then it is normal to have a few sleepless nights while you process and accept the diagnosis. However, the position you sleep in can make a difference to your symptoms and can actually help your condition:
- Relieve the pressure – when we lay flat in bed, gravity pulls us onto the mattress which exerts pressure on various parts of the body and can cause strain on the heart and lungs. Sleeping elevated can ease this pressure and improve the function of heart and lungs whilst the body is repairing itself. Elevating by piling pillows is not very effective as they are unstable and can move as you sleep. Instead use a wedge pillow which provides stable support for the whole torso. This not only relieves pressure on the chest but also keeps your spine straight and prevents the neck pain caused by piling pillows.
- Which side is best to sleep on left or right? – if you are a side sleeper then sleeping on your side maybe more comfortable for you. However, there is debate as to whether one side is better than the other in terms of heart health. Due to the circulation of your blood and that it returns to your heart on the right side, it is often recommended to avoid sleeping on your right for an extended period of time. However, in contrast to this, a study in 2018 showed there were noticeable changes in ECG readings in healthy patients who slept on their left. Whichever side you choose (or advised) to sleep on, use a positioning pillow to keep you in place and to ease the strain of maintaining this position on your chest.
- Edema? – many people with heart disease also suffer or are susceptible to edemas. If this is you then sleep with your legs elevated on a bolster pillow to improve drainage.
How Should you Sleep after Heart Surgery?
There are currently 900,000 cardiac surgery procedures carried out in the USA each year and this number is predicted to rise to 1.3 million by 2026. The most common surgeries include coronary artery bypass graft (CABG) procedures and surgical heart valve replacement (SHVR), both of which involve invasive techniques that require careful post-surgery management. The quality and quantity of a patient’s sleep is highly likely to be affected in the weeks and months both before and after cardiac surgery. In an article published on the NCBI, Wen-Chun Liao concludes that...
“Physical factors, including pain, dyspnea, nocturia, and cardiac function, and environmental factors, including noise, light, and procedures on patients, were associated with sleep disturbances during hospitalization. Psychological factors, including anxiety and depression, affected sleep during the first 6 months after discharge”
If we look at the different stages of recovery after cardiac surgery, then we can adopt the recommended strategies for improving the quality and duration of sleep.
Immediately after surgery you are likely to spend some time in ICU and then on the cardiac ward before being discharged home. Sleeping in hospital is often difficult due to the unfamiliar smells, sounds and general activity that is not experienced when sleeping at home, never mind the pain from the surgical site and the aftereffects of the anaesthesia. The following ideas may help improve your sleep whilst in hospital:
- Sleeping Position – immediately after surgery you will have no option but to sleep on your back and elevated. The top of your hospital bed will be raised and there will be various tubes and wires coming out of your torso that need not to be dislodged. Therefore, back sleeping is essential and the only practical position. If this is not a natural sleeping position for you then it is a good idea to practice this on the run up to your operation so that it does not seem as unfamiliar to you post op. Sleeping elevated is also highly recommended to help with fluid management. A natural consequence of most open-heart surgery procedures is the production of excess fluid around the heart. It is for this reason that drain tubes are put into the chest to drain this fluid away in the days immediately following surgery so that it does not impede cardiac function.
- Reduce the unfamiliar – everything about sleeping in a hospital environment is unfamiliar! Take familiar items with you that ‘feel and smell’ like home so that you are more relaxed. Use a sleep mask to blackout the background lights that are on through the night and ear plugs so you are not disturbed by nursing staff or other patients moving around.
The joy of being discharged from hospital and the thought of getting a good night’s sleep in your own bed is often reduced by the practicalities of the reality you face. There are many reasons that your sleep will be disturbed for the first month or so once returning home. These may include:
- Pain and discomfort from the wound side and breastbone wires.
- The effects of the anesthesia which can last a couple of weeks.
- Unable to carry out your usual activities causes a change in routine which itself is often a cause for sleep disturbance.
- Frustration at not being able to do certain things for yourself or concerns over work and money can also lead to a restless mind at night, preventing sleep.
- Try not to sleep in a recliner – upon arriving home after cardiac surgery many people try to sleep in a recliner to remain upright and reduce the pain and strain on their chest from getting into and out of bed. However, sleeping in a recliner is not going to enable you to have the deep and restful sleep that you need. You need to send your brain ‘normal’ signals of the difference between day and night. If you spend most of the day resting in the recliner, then you need a different environment for night time sleeping. The old adage of ‘sleeping better in your own bed’ is true. The firmness of the mattress, your pillow, the smell of your laundry powder on your sheets are all sub-conscious signals that tell your body to rest and sleep.
- Invest in a good quality wedge pillow – these pillows can be used for many things, but their primary use is to help people sleep elevated. Sleeping elevated has several benefits when recovering from heart surgery. As previously mentioned, it eases the pressure on your chest when lying down so puts less strain on your heart. Additionally, it will reduce the pressure on your sternum and so ease this pain when lying down. The elevation will also help any further fluid that is produced around the heart to drain and reabsorb. It will also ease the pain when transitioning between sitting and lying as the distance you need to move is reduced. If you use an adjustable wedge pillow, such as the Luxelift from Zenesse Health, which is designed for post-surgery recovery you are able to lower the height as you heal which eases you gradually back to laying flat when you feel able to. It also uses cooling memory foam technology to prevent overheating at night leading to a more comfortable sleep. If you use your normal pillow on top of the wedge pillow, then you will still have the smell and comfort you are familiar with but with the added relief of the elevation.
- Try not to daytime nap – your sleeping pattern will have been disturbed by your stay in hospital and it is important that you try to get back to your usual sleep routine as soon as you can. The effects of medication can make you feel like sleeping during the day, but try to avoid daytime sleeping, or if you have to nap keep it to one 20 minute sleep a day. The quicker you can get back to your usual sleep pattern the better you will sleep at night.
- Prefer to Side-sleep? - If you naturally sleep on your side then a few weeks after your operation you can try sleeping on your side. Use a positioning pillow or a half moon bolster pillow behind your back to add support so that there is less tension put on your rib cage to keep you in that position. Avoid sleeping on your stomach until your sternum has completely healed.
- Swollen legs? – It is common to have swelling in the legs and ankles which can last a number of weeks after surgery. If you suffer with this then sleep with your legs elevated on a bolster or wedge pillow to help the fluid drain and reduce the retention. It is also advisable to sleep with your legs elevated for a couple of weeks if you had CABG which used a blood vessel from our leg.
- Seek help – if your usual sleep pattern has not returned 3 months after your operation then seek medical advice before a new unhealthy sleep pattern becomes established.