We chatted with Norma Caples, Lead Nurse for the National Clinical Programme for Heart Failure HSE, about why people with cardiovascular disease may be having trouble sleeping at this time.

Q. Why is it important that people with cardiovascular disease get a good night’s sleep?

Studies have shown that people who have restless, broken sleep or insomnia have increased levels of cortisol, stress hormones, an increased metabolic rate and endothelial dysfunction (a predictor of heart disease). All of these can increase the risk of cardiovascular disease  regardless of age, weight, smoking and exercise habits. Restless/broken sleep or insomnia has also been linked to risk factors for cardiovascular disease such as diabetes and high blood pressure.

Q.What are the reasons that people with cardiovascular disease may have difficulty sleeping?

Some people may have a condition called sleep-disordered breathing. This  is an umbrella term for several chronic conditions in which partial or complete cessation of breathing can happen a number of times throughout the night. Symptoms include waking with dry throat, headache and daytime sleepiness or fatigue that interferes with your ability to function and reduces quality of life. If these symptoms occur it is best to see your doctor in case more investigations are needed.

Anxiety, stress, and depression can also interrupt sleep and it is very normal in this unprecedented time of the coronavirus pandemic to feel more anxious than normal. You can find some expert tips on managing your mental health in the time of Covid-19 here

Q. Do people with cardiovascular disease need more or less sleep than others?

Sleeping less than six or more than nine hours a night has shown to increase the risk of cardiovascular disease. Research has also suggested that afternoon naps can help to keep the heart healthy.

Q. Do some heart conditions make it more difficult to sleep than others?

Sometimes people with heart failure can have something called Paroxysmal Nocturnal Dyspnea or PND. This is when they have deterioration in their heart failure and wake from their sleep with severe shortness of breath and coughing

Q. Do certain prescribed medications for heart failure affect sleep and is there a way to best manage these?

Some statins can cause nightmares and vivid dreams but your doctor or nurse can change the medication to a different type or advise you to take it at a different time. Also beta blockers can cause insomnia and nightmares. If you are experiencing these symptoms its important that you contact your doctor or nurse.

Q. Is there a particular side you should sleep on if you have heart disease?

No, sleep on whatever side is most comfortable for you.

Q. What tips can you give people with heart failure who are having difficulty sleeping so that can get a better night’s sleep?

It is best to let your doctor or nurse know that you are having difficulty sleeping as they may need to do further investigations. In my experience anxiety is a big problem. Joining groups like the Irish Heart Foundation heart failure support group is a great help as having support can help lessen your anxiety. It is great to talk to people who have had similar experiences.

The Irish Heart Foundaiton heart failure support group also provides access to counselling. This is helpful when people are trying to adjust to a new way of life. The life or person they knew themselves as has changed. This can reduce confidence and create a feeling of being “lost”. I would strongly advise people to talk to their doctor or nurse about available supports.

The Coronavirus pandemic has led to increased levels of fear and anxiety for many people living with cardiac issues. The Irish Heart Foundaiton has developed a Facebook Heart Support group and people engaging with this have reported how they find it extremely supportive at this time.

We are here for you

The Irish Heart Foundation’s nurse support line is available five days a week. Anyone living with heart disease and stroke who has concerns or questions about the coronavirus can contact the nurse support line on 01 668 5001 or support@irishheart.ie.

The Irish Heart Foundation’s new heart support group is on Facebook. Anyone who lives with heart failure or another heart condition or has a family member living with a heart condition can join here: www.facebook.com/groups/heartsupportnetwork/

The Irish Heart Foundation runs 21 stroke support groups and 5 heart failure groups around the country. All these groups have moved to telephone and online support. For more information, see https://irishheart.ie/get-support/.