You have probably always been told to sleep at least eight hours a night, but people with pulmonary hypertension (PH) know that their bodies can need much more rest than that. That may be because the high pulmonary pressures in PH put stress on the heart and makes it work harder to pump blood to the body, requiring more energy.
Typically, deep sleep is restorative for the heart. During sleep, heart rate slows, breathing stabilizes, and blood pressure drops by about 10–20% in most people compared to daytime levels. This drop decreases the stress on your heart, giving it a chance to recover and regenerate from daytime stress and strain.
Poor quality sleep, or not enough deep sleep, doesn’t give your heart a chance to regenerate and is linked to high blood pressure and heart disease.
A common sleep disturbance is regularly having trouble falling asleep or staying asleep, or both, also known as insomnia. And many PHers may also have sleep apnea, where airways become regularly blocked during sleep. Not only does this reduce the quality and restfulness of sleep, but this type of regular sleep disturbance also leads to low oxygen levels at night, triggering damage in the pulmonary arteries that can lead to or worsen high pulmonary pressures.
Dr. Matthew Walker, the director of the Center for Human Sleep Science at the University of California, Berkeley, has found that one way poor sleep exerts negative effects on the heart is due to increased inflammation. In a recent study, he and his team of researchers found that disruptive sleep led to increased levels of white blood cells, which play a significant role in the immune system and inflammatory pathways.
Although scientists do not yet understand the precise way that poor sleep affects white blood cell levels, Dr. Walker explains in his study that reduced sleep is linked to prolonged high levels of cortisol—the hormone released in response to stress—which could lead to higher white blood cell production.
According to Dr. Walker, getting enough restful sleep is a way you can reduce inflammation in your body and help protect your heart health.
Tips for better sleep:
Establish a regular sleep schedule and get enough natural light during the day
Avoid blue light from screens 1-2 hours before bed by using blue light filters or reading a book instead of reading on your smartphone
Keep your bedroom cool and dark—use blackout curtains to block out light from streetlamps or neighbours
Try using a white noise machine to block out any disruptive noise
If you’re on oxygen, ensure you are getting enough oxygen flow during the night
If you think you may be experiencing sleep apnea or insomnia, talk to your doctor or PH team about getting a sleep assessment
If you have trouble breathing while lying flat, elevate your head while sleeping so your head is higher than your heart. By elevating your head, you will reduce the stress on your heart which can improve your breathing and allow you to get better sleep. You can do this by raising the head of your bed by placing 6-inch wood blocks under the legs at the head of your bed frame, by placing a thick blanket or pillows under the head of your mattress, or by using an orthopedic foam wedge placed on top of your mattress under your chest and head.
Some of the best advice I ever got from my social worker was, “if you’re tired, sleep!” And I hope this post will help remind you to always listen to your body and get more Zzzs.