Immediately following a heart attack or heart surgery, the emphasis is on taking medications, dietary considerations, activity guidelines and post-procedure counselling appointments. Sleep is often forgotten, and after a cardiac event, it is one of the strongest healing tools the body has at its disposal.
At rest, the heart rate falls, the BP falls, and the body goes to work repairing and resting. For cardiac patients, good-quality sleep is not a luxury; it is a medical necessity. But sleep problems are very prevalent following a heart attack or heart surgery. Many patients struggle with falling asleep, waking up more than once during the night, having anxiety at the time of going to sleep, or having a difficult time falling asleep due to disturbing thoughts and dreams of what they’ve experienced.
Why Sleep Becomes Difficult After a Heart Attack or Surgery?
One of the most apparent obstacles is physical pain. It can be difficult to find a comfortable position to sleep once you have had heart surgery, especially after the surgery, or have a sore chest, or an uncomfortable feeling from a healing sternum. After a heart attack, if you don’t have surgery, the pain and discomfort in your chest can last for weeks, and you may become anxious about lying flat.
There is a strong element of anxiety and fear. Many cardiac patients become afraid to sleep, especially during the first few weeks after a heart attack, fearing something will happen while they are sleeping without anyone being around to see. This anxiety is natural, but it can actually make sleeping more stressful, and the opposite of what you’re trying to achieve.
Some cardiac recovery medications, such as some blood pressure medications, diuretics and beta-blockers, have side effects that may result in poor sleep or waking up at night. Be careful not to suddenly discontinue medications without talking to your cardiologist if you are having a problem sleeping due to the medication.
In addition, individuals with heart disease are more likely than individuals in the general population to experience sleep apnea, a condition that causes breathing to pause many times throughout sleep, and sleep apnea tends to hurt sleep quality. Tell your doctor if you snore loudly or if you don’t feel rested after a night’s sleep.
For cardiac recovery, here are some tips for better sleep:
Establish a bedtime routine and get up at the same time each day, even on weekends, to help maintain your body’s internal clock and make sleep more attainable as time goes on. A consistent sleep routine helps the brain realise it’s time to sleep. Taking a warm bath, reading or gentle breathing exercises during the 30 minutes before going to sleep can all help to create a more natural sleep transition without a lot of effort.
Discovering a comfortable sleeping position is a great way to prevent aches and pains
During the first few weeks following heart surgery, it is frequently the most comfortable and recommended position to lie with a stiff back. If sleeping with the head and upper body slightly elevated, with an extra pillow or an adjustable bed, some patients experience less discomfort in their chest and easier breathing when they sleep at night. In the first few weeks after surgery, do not lie on your stomach, since it puts pressure on the healing chest area.
Maintain Bedroom Cool, Dark and Calm
The context in which one sleeps is extremely important. A cool, dark and quiet bedroom always helps for better sleep. Try to avoid screens – phones, tablets and TV – for a minimum of 45 minutes before going to sleep, as the light they give out disrupts the body’s natural sleep signals. Maintain a comfortable temperature in the room, and use lightweight, breathable bedding that won’t overheat at night.
Tackle anxiety regarding sleep
Sometimes it’s better to acknowledge and accept fear and anxious thoughts, rather than trying to squash them. Simple breathing exercises: inhale slowly for four counts, hold for two counts and then slowly for six counts. Turning on the calming part of the body and it can make a physical difference to the feeling of anxiety at bedtime. It can also be of great benefit if a counsellor and/or psychologist is available who can have had experience working with cardiac patients.
Limit Fluids in the Evening
Several people with cardiac disease use a diuretic drug to make them pee more. If clinically appropriate and by your doctor’s advice, these medications may be taken in the morning instead of the evening to decrease nighttime bathroom use, which can disrupt sleep, or cause sleep disturbances. Avoid drinking fluids in the 2 hours leading up to sleep as well to reduce unexpected arousals during the night.
Don’t have caffeine after lunchtime.
Tea, coffee, and caffeinated cold drinks are stimulants to the nervous system and can cause a delay in getting to sleep as well as make the sleep shallower, even several hours before retiring to bed. Caffeine-free substitutes after midday are a quick and easy habit that can make a significant improvement for cardiac patients when it comes to getting a good night’s sleep.
Make frequent short rest breaks during the day consciously
It is expected to feel tired as part of the cardiac recovery process, and short rest periods during the day are fine in the early weeks. But long naps during the day, especially late in the afternoon, can make it more difficult to fall asleep at night, and the entire night’s sleep may suffer. Limit daytime sleep to 20 to 30 minutes and try to avoid daytime naps after 3 pm if possible.
Check with your Doctor about Sleep
If sleep disturbances continue beyond the first couple of weeks of recovery or if they are a significant problem that is impacting your mood, energy and daily functioning, it is important to discuss this with your cardiologist or treating doctor.
Conclusion
Good sleep is not separate from cardiac recovery – it is central to it. The body heals most effectively during sleep, and investing in sleep quality during the recovery period is one of the most important things a cardiac patient can do for their long-term health.
At Criticare Hospital, Lucknow, our cardiology team provides comprehensive cardiac care that extends beyond the clinical to the practical – helping patients recover fully and confidently at every stage. If you have concerns about your recovery or your sleep after a heart event, reach out to our team today.
