How Insomnia Affects Your Heart

While you sleep, your body is performing maintenance functions that help keep your vital organs and body systems working.

Dr. Sanjiv Patel, a board certified interventional cardiologist at Memorial Care Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, California, told Healthline that many things happen during sleep that benefit your heart.

These include:

• a slower heart rate
• lower blood pressure
• management of stress hormones
• insulin and blood sugar regulation
• cell and tissue repair

Long-term insomnia increases stress and anxiety, which strains the cardiovascular system over time. This is particularly a concern in a person who already has a condition like high blood pressure, Patel told Healthline.

“If you don’t sleep well, stress hormones can build up and cause inflammation. This can potentially trigger a buildup of plaques, which can become unstable and cause heart attack or stroke,” said Patel.

Patel said insomnia can harm the heart in less direct ways as well.

Sleeping helps regulate hormones that control daytime hunger. Lack of sleep can lead to overeating. In addition, fatigue may make you less active. Both of these consequences can result in increased weight and insulin resistance, which raise the risk of diabetes and heart disease.

A 2018 review of studies on sleep deprivation and weight found that lack of sleep contributes to health outcomes that, in turn, are known to increase risk for heart disease. These include:

• weight gain
• obesity
• salt retention
• increase in inflammatory markers
• insulin resistance
• high blood pressure

Research from 2017 also shows that insomnia itself is an important risk factor for cardiovascular disease.

Your level of risk depends on your age and other underlying conditions.

“A young, healthy person can have a short-term issue with not sleeping well and will probably be fine,” said Patel. “For someone who is older and has underlying conditions, insomnia can throw them into an unstable situation.”

Sleep conditions that can affect heart health include:

• Chronic insomnia. Many adults have troubles sleeping from time to time. Chronic insomnia is when you have trouble falling or staying asleep that lasts for at least 3 nights per week for at least 3 months. Over time, it has been linked to high blood pressure and heart disease, according to the Centers for Disease Control and Prevention (CDC).
• Obstructive sleep apnea. This is a condition in which blocked airways cause short pauses in breathing during sleep. According to the CDC, lack of oxygen due to sleep apnea can increase the risk for high blood pressure, heart attack, and stroke.
• Narcolepsy. Narcolepsy is a chronic sleep disorder where the brain struggles to control sleep and wake cycles, which leads to disrupted sleep and daytime sleepiness. Narcolepsy and narcolepsy treatments may increase blood pressure and contribute to other risk factors linked to heart disease and cardiovascular events. More research is need to understand these associations, according to the American Heart Association (AHA).
• Restless legs syndrome (RLS). People with RLS have an overwhelming urge to move their legs, particularly at night, which can interfere with good sleep. Research from 2021 suggests that RLS is associated with higher cardiovascular risk, especially when untreated. More studies are needed to fully understand this effect.

Sleep is important to physical and mental health. Even in the short term, poor sleep can contribute to:

• moodiness and irritability
• concentration and memory problems
• daytime sleepiness and fatigue
• headache
• gastrointestinal symptoms
• risk of accidents

Insufficient sleep has been linked to the development of certain health concerns that increase the risk of heart disease, heart attack, and stroke, per the CDC. Some of these are:

• type 2 diabetes
• obesity
• depression

According to the National Heart, Lung, and Blood Institute, chronic insomnia can raise the risk of developing other health conditions or making existing health conditions worse. These include:

• anxiety
• chronic pain
• pregnancy complications
• inflammation
• dampened immune response

The CDC recommends most adults need at least 7 hours of sleep per night. The AHA says that a healthy diet, regular exercise, and stress management may promote the good sleep you need to keep your heart healthy.

Sleep hygiene

Healthy sleep habits like these can get you on track for better sleep:

• Make a sleep schedule where you aim for the same bedtime and same wake-up time every day.
• Avoid daytime naps if you can.
• Get some exercise during the day, but not within a few hours of bedtime.
• Don’t eat within a few hours of bedtime. Avoid alcohol, caffeine, and foods that are high in fats and sugars.
• Keep the bedroom cool, quiet, and comfortable.
• Clear the bedroom of electronic devices that beep or glow.
• Take an hour if possible to wind down before bedtime.

Cognitive behavioral therapy (CBT)

CBT is a short-term form of psychotherapy that can help you to identify unhelpful thoughts and behaviors and learn more effective coping strategies. It may involve:

• engaging in talk therapy
• trying meditation or relaxation techniques
• learning about good sleep habits
• putting it all into practice

CBT can be performed by a doctor, therapist, or other mental health professional. After your first session, you’ll have a detailed plan for a set number of sessions to achieve your goals.

Medication

In some cases, a doctor might prescribe medication to treat insomnia along with sleep hygiene and CBT. Some medication categories approved by the Food and Drug Administration (FDA) include:

• benzodiazepines
• non-benzodiazepine receptor agonists
• melatonin receptor agonists
• specific antihistamine drugs
• dual orexin receptor antagonists

Other medications — such as certain antidepressants, antipsychotics, and anti-anxiety medications — are sometimes prescribed off-label for insomnia.

Some people try over-the-counter (OTC) medications and dietary supplements to improve sleep, including:

• diphenhydramine (Benadryl)
• doxylamine (Unisom)
• melatonin

According to the National Institutes of Health, research hasn’t proven melatonin to be effective in treating insomnia. Dietary supplements can also interfere with other medications.

And antihistamines (diphenhydramine and doxylamine) used chronically can be unsafe for some people and are associated with the development and progression of dementia.

All medications and supplements have side effects, and sleep aids can be habit forming. Most are meant for short-term use. Both prescription and OTC options should be used with a doctor’s guidance.

Over time, insomnia can increase the risk of high blood pressure, cardiovascular disease, and heart attack. If you already have an underlying condition, insomnia can make matters worse.

There are steps you can take to manage insomnia on your own.

“If you’ve had insomnia for 4 weeks, see a primary care physician to find out what’s going on,” recommended Patel.