Steps to improve your overall sleep quality should be personalized with help from your healthcare team. That’s especially important if you’re taking medicines for heart failure or using devices for breathing support. Consider the expert recommendations below as a starting point.
1. Adjust Diuretic Timing to Curb Nighttime Bathroom Trips
“Decreasing fluid consumption and taking diuretics earlier in the day will help minimize trips to the bathroom at night to urinate, which should protect sleep,” says Finet.
Check with your healthcare provider before adjusting the timing of your medications. But typically, taking diuretic medications in the morning or at least six hours before bed is considered a good practice.
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2. Follow Your Heart Failure Treatment Plan to Limit Swelling
Dietary sodium restriction and tailored fluid strategies are standard methods used to control volume in heart failure, including ATTR-CM.
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Restricting sodium can lessen stress on your heart and improve symptoms, boosting sleep quality. Evidence supports limiting fluid intake to 50 ounces (oz) a day and salt intake to 2,000 milligrams (mg) a day, though you should ask your healthcare provider for personalized recommendations.
3. Treat Sleep Apnea if You Have It
A large proportion of people with ATTR-CM have sleep-disordered breathing. So, healthcare providers should screen for OSA when a person has daytime sleepiness, frequent nighttime urination, or witnessed apneas (an event in which breathing is interrupted), says Finet.
According to guidelines from the American Heart Association, early recognition and treatment of sleep apnea is part of comprehensive care for cardiac amyloidosis.
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“Therapies to manage sleep apnea such as CPAP and BiPAP machines [can] be of tremendous help in improving sleep,” says Finet.
4. Elevate Your Upper Body if You Feel Breathless Lying Flat
Fluid retention and stiff heart muscle can make breathing harder when lying flat (a condition called orthopnea) or trigger abrupt awakenings with a sensation of suffocation a few hours after sleep begins. Elevating your upper body and head with a wedge pillow or an adjustable bed frame can make breathing easier and reduce these awakenings.
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5. Address Neuropathy Symptoms That Wake You Up
Work with your cardiologist and a neurologist if needed to manage painful neuropathy, a recognized symptom of ATTR-CM.
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Optimal management of neuropathy can help reduce nighttime burning, tingling, or restlessness, thereby improving sleep, says Finet.
6. Practice Smart Sleep Habits That Complement Medical Care
Finet recommends that people with ATTR-CM practice good sleep hygiene. Some ways to do that are:
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- Exercise regularly.
- Go to bed and get up around the same time every day.
- Avoid caffeine or heavy meals before bedtime.
- Limit alcohol if you drink it.
- Don’t smoke.
