Wednesday, February 1, 2023

Congestive Heart Failure And Excessive Sleeping

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Why Is This A Big Deal

How to sleep better with congestive heart failure

For people with OSA, it becomes difficult to keep the upper airway open during sleep because weight overpowers the muscles that hold it open. Each time the airway closes during sleep, there is a pause in breathing it can happen five to 30 times an hour or more, causing the sleeper to wake up suddenly, gasping for air.When the air flow stops, the body releases stress hormones, which over time can lead to heart disease the leading cause of death in the United States stroke and high blood pressure. It also can increase the risk of type 2 diabetes, liver problems and metabolic syndrome.Its also associated with obesity, and experts say it can be part of a vicious cycle in which the sleep deprivation it causes can lead to even more obesity, which in turn makes the condition worse.

Sleep Disorders And Heart Health

Many sleep disorders have detrimental effects on heart health. Insomnia, one of the most common sleep disorders, is often accompanied by insufficient sleep and can lead to elevated cardiovascular health risks.

Obstructive sleep apnea is a breathing disorder that is linked to heart disease, obesity, diabetes, stroke, and high blood pressure. People with OSA have lapses in breathing during sleep when their airway gets blocked.

Interrupted breathing from OSA causes fragmented sleep, which is one reason why the condition is tied to multiple cardiovascular problems. In addition, disturbed respiration reduces the amount of oxygen in the blood, which may worsen the impacts of OSA on heart health.

Disorders of abnormal movement during sleep, such as restless leg syndrome and periodic limb movement disorder, have also been linked to heart problems. While the exact explanation is unknown, it may relate to abnormal activation of the cardiovascular system that occurs with these conditions and induces elevated and fluctuating heart rate and blood pressure.

Circadian rhythm sleep disorders, which occur when a persons internal clock is misaligned with day and night, have been associated with cardiovascular problems. For example, people who work night shifts and have to sleep during the day have heightened risks of hypertension, obesity, and diabetes as well as cardiac events like a stroke or heart attack.

Sleep And Coronary Heart Disease

Coronary heart disease is the leading cause of death in the United States. Also known as coronary artery disease, it happens when plaque builds up in the arteries, hardening and narrowing them in a condition known as atherosclerosis. This reduces the ability of the heart to get enough blood and oxygen.

Research has found that sleep deprivation contributes to atherosclerosis. Plaque forms as a consequence of inflammation, which involves white blood cells, which are produced by the immune system, to collect in the arteries. Poor sleep triggers chronic inflammation, which contributes to plaque formation and hardening of the arteries.

The impact of sleep deprivation on coronary heart disease is also believed to be influenced by sleeps effects on blood pressure. Hypertension strains the arteries, making them less effective at bringing blood to the heart and as a result contributing to heart disease.

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Changing The Natural History

Improvement of cardiac function can improve Cheyne-Stokes respiration associated with heart failure. It is important to optimise the medical treatment of the underlying heart disease before considering specific treatment for periodic breathing, which includes drug treatment, supplemental oxygenation, and ventilation.

Theophylline, morphine derivatives, and supplementation of inhaled oxygen with 3% carbon dioxide have been successfully applied under experimental conditions in small studies. Supplementing oxygen overnight with flow rates of two to three litres per minute can reduce Cheyne-Stokes respiration by half and can improve sleep architecture exercise performance and cognitive function may improve although daytime symptoms may not. Nocturnal, non-invasive ventilation using continuous positive pressure ventilation for a period of one month can significantly reduce the frequency of apnoeas and hypopneas, increase oxygen saturation and Pco2, and normalise tidal volume during sleep.

What Happens To Your Heart When Your Body Is Tired

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At Rest, Your Heart Is Racing According to Bruno, even though your body is exhausted all the time, your heart rate might still pound away frenetically. A racing heart at rest can be frightening since it increases the risk of cardiovascular disease and heightens emotions of stress. But it’s not just a normal response to anxiety or fear your heart must also be kept active to maintain healthy blood flow and prevent clotting.

When you are tired, your body uses more energy thinking about moving and maintaining balance. So it makes sense that your heart would need to work harder too. Studies have shown that heart rates actually rise when people sleep because their bodies prepare for action by getting ready to fight or flee from danger. While sleeping, the body is no longer receiving signals from the environment around it so this instinctive reaction must be suppressed while asleep so as not to cause alarm.

The good news is that your body will eventually collapse into exhaustion and finally be able to repair itself. When your muscles are used up, they shut down to save energyâthis is called “muscle relaxation.” At first, these shutdowns occur only in specific muscles, but over time, all of your muscles tend to relax more and more until you are basically paralyzed from the waist down. This is why it’s important to give your body the opportunity to recover sometimesâespecially if you’re an athlete who relies on your muscles daily.

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How Is Chf Diagnosed

After reporting your symptoms to your doctor, they may refer you to a heart specialist, or cardiologist.

The cardiologist will perform a physical exam, which will involve listening to your heart with a stethoscope to detect abnormal heart rhythms.

To confirm an initial diagnosis, a cardiologist might order certain diagnostic tests to examine your hearts valves, blood vessels, and chambers.

There are a variety of tests used to diagnose heart conditions. Because these tests measure different things, your doctor may recommend a few to get a full picture of your current condition.

What Is Routine Sleep Apnea Screening

Regarding sleepiness, the data suggest that the Epworth Sleepiness Score is rarely increased in CHF patients, suggesting that daytime sleepiness is not present.13,25 Of note, the ESS asks questions regarding the propensity of the individual to fall asleep at inopportune times, which might be insensitive in people who are relatively sedentary. For example, an individual with comorbidities who lies in bed or on the sofa watching television might intermittently fall asleep throughout the day. However, such an individual would deny a high risk of falling asleep in the settings queried in the ESS . Thus, the metrics for sleepiness might be unreliable in CHF patients, again suggesting the need for more data. Our clinical experience suggests that although CHF patients are less likely to report excessive sleepiness,13 especially as judged by the ESS, many afflicted patients do nonetheless have symptoms of disturbed sleep . Thus, a careful history can help with case-finding and potentially reduce the need for screening of truly asymptomatic individuals.

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Chf Contributing To Rsd

CHF may result in fluid retention and deranged autonomic control. Commonly, patients with CHF complain of dyspnea on exertion, then at rest or during sleep, where it is known as orthopnea or paroxysmal nocturnal dyspnea. Fluid retention results in interstitial edema, pleural effusion and alveolar edema. There may also be pedal edema and at times gut wall edema may lead to malabsorption.

Deranged autonomic control is thought initially to be compensatory for the low cardiac output. This has an effect upon sleep quality in addition to the development of tachyarrhythmias . Poor sleep quality can lead to daytime fatigue, rather than true sleepiness .

Fluid retention can contribute to RSD via several mechanisms. First edema of the upper airway can narrow the lumen , and possibly the surface tension of the upper airway lining thus predisposing to upper airway collapse .

Second, shifting of fluid from lower limbs and abdomen to the thorax can contribute to transient pulmonary edema. This phenomenon is called rostral fluid shift and if concentrated to the lungs cause CSA-CSR, or to the upper airway, OSA. Given that 50% of the oxygen stores are kept within the lungs, a reduction in size or function can exacerbate periodic breathing .

Figure 2Figure 3

Isnt Sleep Apnea Just A Fancy Name For Snoring

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Not at all. Snoring is that annoying sound that occurs when air passes relaxed tissues in your throat as you sleep. Sleep apnea is a disorder in which a persons breathing repeatedly starts and stops during sleep. Not everyone who snores has sleep apnea, but many who have sleep apnea do snore regularly and loudly. One in five adults suffers from at least mild sleep apnea it afflicts more men than women. The most common type is obstructive sleep apnea , in which weight on the upper chest and neck contributes to blocking the flow of air. A less-common type, central sleep apnea , occurs when the brain fails to send regular signals to the diaphragm to contract and expand. CSA has been associated with brain stem stroke.

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What Sleep Conditions Can Hurt My Heart Health

Over time, sleep problems can hurt your heart health.

Sleep apnea happens when your airway gets blocked repeatedly during sleep, causing you to stop breathing for short amounts of time. Sleep apnea can be caused by certain health problems, such as obesity and heart failure.

Sleep apnea affects how much oxygen your body gets while you sleep and increases the risk for many health problems, including high blood pressure, heart attack, and stroke. It is more common among Blacks, Hispanics, and Native Americans than among whites.7

Insomnia refers to trouble falling sleep, staying asleep, or both. As many as 1 in 2 adults experiences short-term insomnia at some point, and 1 in 10 may have long-lasting insomnia.8 Insomnia is linked to high blood pressure and heart disease. Over time, poor sleep can also lead to unhealthy habits that can hurt your heart, including higher stress levels, less motivation to be physically active, and unhealthy food choices.

For better sleep, get enough natural light, especially earlier in the day. Try going for a morning or lunchtime walk.

Ways To Fight Fatigue From Congestive Heart Failure

If you’re one of the millions feeling worn out from heart failure, take back the day with these fatigue-fighting heart failure solutions.

The term “heart failure” tends to mislead. After all, people who have it don’t necessarily have a heart that has stopped working rather, their hearts can’t pump blood as well as they should.

Still, it’s serious. As your heart works overtime, it can cause tiredness, shortness of breath and a feeling of being simply worn out.

Such are the signs of fatigue, one of the most common symptoms of congestive heart failure. Nearly six million adults in the U.S. live with heart failure, the Centers of Disease Control and Prevention reports, and many of them feel tired when they do even simple things around the house, such as taking a shower.

But luckily, people can thrive with a heart failure diagnosis and fight fatigue along the way. With a few lifestyle shifts , you can bring back more energy into your day. Ask your doctor what’s right for you, and if they give the go-ahead, try these heart failure solutions to combat fatigue and live an active, exciting life.

1. Eat for Your Heart

If you have congestive heart failure, your doctor has likely already given you guidance for a heart-healthy diet. Generally, that means eating more of the good stuff and less of the bad stuff .

2. Renew Your Energy With Exercise

3. Take a Nap

4. Make Time for Mental Health

5. Get Better Sleep

Taking Back Your Day

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How Much Sleep Do I Need

Most adults need at least 7 hours of sleep each night.1 However, more than 1 in 3 American adults say they dont get the recommended amount of sleep.2 While this may be fine for a day or two, not getting enough sleep over time can lead to serious health problemsand make certain health problems worse.

Subjective And Objective Daytime Sleepiness

Sleep

There was no significant difference between the SDB and NoSDB groups for subjective ESS SDB: 7 NoSDB: 9 p=0.55), yet objectively the SDB group were significantly sleepier on the OSLER test min NoSDB: 40.0 min p=0.01).

OSLER results were further separated according to the time of day the test was taken . The current authors found no significant differences in the SL recorded by the OSLER test for each time of day .

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What Happens In Sleep

Normal sleep comprises two phases, non-rapid eye movement and rapid eye movement sleep. Several cycles of NREM and REM occur, each cycle lasting about 90 minutes and containing a greater proportion of REM sleep than that preceding it.

During REM sleep, the rate and variability of breathing is increased and most or all skeletal muscle tone is suppressed because of hyper-polarisation of motor neurons this prevents muscular contraction, even though brain stem motor systems are intensely active. Arousal to respiratory stimuli, such as hypercapnia or the less potent hypoxia, is delayed in REM sleep. During non-REM sleep, however, breathing patterns are extremely regular and slow, with in particular prolonged inspiratory times. This has profound implications for clinical aspects of sleep, including sleep disordered breathing.

Periods of ventilatory instability are common during the onset of sleep even in normal subjects because the control of breathing becomes critically dependent on the chemical/metabolic control system, the result of the abolition of the waking neural drive to breathing and behavioural control systems during NREM sleep. As the subject flips from sleep to wakefulness, a ventilation surge occurs that is large enough to drive the Paco2 below the apnoeic threshold. Any disease process that exaggerates these parameters will sustain periodic breathing during sleep.

More Strategies To Help You Sleep Better

To get a better night’s sleep with heart failure or any chronic condition, the main focus should be on good sleep hygiene, says Khayat. He recommends maintaining a regular sleep and wake time, avoiding alcohol and caffeine before bedtime both of which can disrupt sleep and putting your electronic devices to bed several hours before your bedtime. The light emitted from electronic devices can make it more difficult to fall asleep.

If your doctor says its okay, Khayat also suggests those with heart failure get daily brisk exercise. A cardiovascular routine that lasts 20 or 30 minutes about four to five hours before bedtime helps in improving their sleep consolidation, their ability to generate sleep and to stay asleep, he says.

Freeman is also a big fan of managing stress, whether its yoga, meditation, getting a handle on your finances or other issues that keep you up at night. Today, stress is at an all-time high, he says. The expression Ill lose sleep over it, is true. Stress really impacts how we sleep. Its important to do something mindful and stress relieving for 30 minutes every day.

Lifestyle medicine, as Freeman calls it, which includes managing stress, getting seven hours of sleep each night, exercising regularly, eating a predominantly low-fat, whole food, low-salt plant-based diet, and not smoking, can help manage heart failure symptoms and even prevent the condition from developing in the first place.

Additional reporting by Sandra Gordon.

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Iv Sleep And A Healthy Heart

There are many things you can do to keep your heart healthy. You should be sure to do the following:

  • Eat a balanced diet
  • Watch out for and treat high blood pressure
  • Get regular medical check-ups

Another thing you can do is to make sure that you get enough sleep to keep your body well rested. You can often sleep better by simply following the practices of good sleep hygiene. Sleep hygiene consists of basic habits and tips that help you develop a pattern of healthy sleep. See the Resources section of this site to find out how you can start down the path to better sleep.

Watch for signs that you may have a sleep disorder. Obstructive sleep apnea is a sleep disorder that can put great stress on your heart. Men who are overweight and have large necks are most likely to have OSA.

Symptoms of OSA include the following:

  • Gasping for breath or choking while asleep
  • Trouble staying awake during the daytime

You may not be aware of these signs because they only occur while you are sleeping. Your breathing is normal when you are awake. Ask a bed partner or someone else who has observed your sleep to find out if you snore or stop breathing during your sleep.

If your doctor thinks that you have a sleep disorder, he or she may suggest that you take a sleep study. This is called a polysomnogram. A sleep study is usually done overnight in a sleep center. It charts your brain waves, heart beat, and breathing as you sleep. It also records your eye and leg movements as well as muscle tension.

How Sleep Deprivation Affects Your Heart

An Osmosis Video: Congestive Heart Failure (CHF) Explained

Ealena Callender, OBGYN

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Its difficult to overstate the hearts importance to health. Responsible for pumping blood throughout the body, the heart powers the circulatory system that ensures that all the organs and tissues in the body get the oxygen they need.

Unfortunately, heart problems are a leading cause of illness and death in the United States. While its already well-known that factors like poor diet, limited exercise, and smoking can harm the heart, theres a growing recognition of the dangers of sleep deprivation for heart health.

Sleep provides time for the body to restore and recharge, playing a key role in nearly all aspects of physical health. For the cardiovascular system, insufficient or fragmented sleep can contribute to problems with blood pressure and heighten the risk of heart disease, heart attacks, diabetes, and stroke.

As a result, getting good sleep may help prevent damage to the cardiovascular system, and for people with heart problems, can be part of following a heart-healthy lifestyle.

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