Journal of Hospital & Medical Management

Editorial

Adults who sleep less than seven hours a day are more likely to say they have had health problems such as heart attacks, asthma and depression. Some of these health problems can increase the risk of heart disease, heart attack, and stroke [1]. The relationship between sleep and heart failure is a two-way street. Heart failure means that you may have other health problems, such as sleep disorders. Similarly, sleep disorders such as obstructive sleep apnea (OSA) and insomnia can also exacerbate the symptoms of heart failure [2].

Clinical manifestations of NS include dyspnea, fatigue, nocturia, and fluid retention, which can be associated with pulmonary edema, peripheral edema, and ascites. Regardless of whether your heart is healthy or not, a good night's sleep is important [3]. Rest helps not only your heart, but also your energy levels, mental capacity, and general health. If you can manage to address your sleep issues, you can reduce the strain on your heart. This results in daytime fatigue, inability to concentrate, headaches, irritability, and mental disorders [4].

Studies on the complications of heart failure can affect sleep. For example, chest pain and discomfort can make it difficult to relax and sleep. If you lie in bed, you may not be able to breathe and may have to pee at night.

During the day, you stand or sit up, which causes excess water to accumulate in your legs and feet. However, when you lie down, it gets into your chest and throat. It can block your lungs and airways and make it difficult to breathe [5].

Your doctor may prescribe diuretics to get rid of that extra fluid. However, these medications do not stop working while you sleep, and you may stop sleeping after just one or two trips to the bathroom.

A study by Garcia et al. (8) looked at sleep quality and cognitive function in 159 elderly FS patients. Sleep disturbances (20.8%), hearing loss (49.6%), and bathroom-related sleep disturbances (56.0%) were the most common. Lack of sleep is associated with poorer cognitive function, poorer quality of life, and increased depressive symptoms [6,7].

In another study, OSA is more common among overweight people, but anyone can get it. During sleep, the tissue in the back of the throat relaxes and blocks the airway. As you stop breathing, your brain signals your throat muscles to contract and open the airway again [8]. This can happen dozens or even hundreds of times a night.

Previous studies have shown that insomnia is more common in patients with heart failure. Other researchers have tried to find ways to reduce the frequency and severity of insomnia and its impact on people with heart failure. Despite the evidence for a link between sleep and heart health, the causal mechanisms remain unclear [9]. The link between sleep and hypertension is well supported by objective and self-regulatory sleep data suggesting that shorter sleep duration (<6 hours) predicts higher blood pressure.11-13 Finally, insomnia is known to have an impact on cardiovascular disease.15,16 Influencing lifestylerelated behaviours, such as diet and exercise, can affect heart health.

• Stimulus control

• Limit bedtime activities to sleep and sex (no phones, laptops, or TV).

• Get up at the same time every morning, even on weekends.

• Go to bed only when you are asleep.

• If you don't fall asleep after 20 minutes or so, get out of bed and do something else in low light that will help you relax some where else. Go back to bed only when you are asleep. Repeat.

• Close your mind and go to sleep.

• Don't look at the clock.

• Sleep hygiene

• Avoid naps during the day.

• Avoid caffeine in the afternoon.

• Avoid nicotine, alcohol, and heavy meals within two to three hours of sleep.

• Consistently engage in a relaxing sleep ritual.

• Practice them during the day to help you feel more tired at night.

• Get some light during the day.

• Make sure your room is dark, quiet and comfortable. Use earplugs and eye masks if necessary.

CBT-i Coach is a free, evidence-based phone application developed jointly by the Veterans Health Administration and the Department of Defense It guides you through the process of learning about sleep by developing daily activities [10].

Overcoming Insomnia: A Cognitive-Behavioural Therapy Approach Workbook, by Jack Edinger and Colleen Carney, provides information about healthy sleep and the reasons for improving sleep habits. Sleep diary, assessment forms, and other assignments are included [11]. It is designed to be used in conjunction with face-to-face therapy. It can be used on its own, but it is not intended to replace therapy for those who need it.

References

1. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr (2013) 2013 ACCF/AHA. Guideline for the management of heart failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 128: 240-327.
2. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, et al. (2013) Heart disease and stroke statistics-2013 update: a report from the American Heart Association. Circulation 127: 6-245.
3. Roger LV (2013) Epidemiology of Heart Failure. Circ Res 113: 646-659.
4. McMurray JJ, Adamopoulos S, Anker SD, Auricchio A, Böhm M (2012) ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 14: 803-869.
5. https://sleepfoundation.org/insomnia/content/what-causes-insomnia
6. Rodríguez PK, Strohl KP, Hadziefendic S, Piña IL (2005) Sleep symptoms and clinical markers of illness in patients with heart failure. Sleep Breath 9: 127-133.
7. Broström A, Strömberg A, Dahlström U, Fridlund B (2004) Sleep difficulties, daytime sleepiness, and health-related quality of life in patients with chronic heart failure. J Cardiovasc Nurs 19: 234-242.
8. Garcia S, Alosco ML, Spitznagel MB, Cohen R, Raz N, et al. (2012) Poor sleep quality and reduced cognitive function in persons with heart failure. Int J Cardiol 156: 248-249.
9. Wang T, Lee S, Tsay S, Tung H (2010) Factors influencing heart failure patients’ sleep quality. J Adv Nurs 66: 1730-1740.
10. Chimluang J, Aungsuroch Y, Jitpanya C (2017) Descriptors of insomnia among patients with heart failure. J Med Assoc Thai 100: 403-409.
11. Suna JM, Mudge A, Stewart I, Marquart L, O'Rourke P, et al. (2015) The effect of a supervised exercise training programme on sleep quality in recently discharged heart failure patients. Eur J Cardiovasc Nurs 14: 198-205.