When people list what’s good for the heart, they usually name food, exercise, and not smoking. Sleep tends to get left off, or treated as the thing you cut when the day runs long.
That’s changed. In 2022, the American Heart Association added sleep to its list of core heart health measures, now called Life’s Essential 8. Sleep and heart health are closely linked: the NHLBI recommends 7 to 9 hours of sleep a night for adults, and ongoing lack of sleep is linked with a higher risk of high blood pressure, heart disease, and stroke. Short nights now and then are part of life, and almost everyone has them. What matters is the pattern over weeks and months.
Here’s what is known about how sleep affects your heart, habits that may help you sleep better, a two-week sleep log to fill in, and the nighttime signs that are worth a doctor’s visit.
How sleep affects blood pressure and the heart
Sleep isn’t downtime for your body. During healthy sleep, your heart rate and blood pressure go down, which gives your heart and blood vessels a regular period of lower strain. When sleep is short or broken night after night, that rest period shrinks.
The NHLBI explains that sleep deficiency, which includes not sleeping enough, sleeping at the wrong times, or having poor-quality sleep, is linked to a higher risk of several conditions, including:
- High blood pressure
- Heart disease
- Stroke
- Obesity
- Type 2 diabetes
Many of these feed into each other. Poor sleep can also make other heart-healthy habits harder: you’re more likely to skip a walk, reach for sugary snacks, or lean on caffeine when you’re tired.
If you’re working on your blood pressure, sleep belongs on the list next to sodium and activity. Our guide on how to lower blood pressure builds a regular bedtime into its habit plan.
How much sleep adults need, and what counts
The NHLBI recommends 7 to 9 hours of sleep a night for adults. The AHA’s Life’s Essential 8 uses the same range.
Hours aren’t the only thing that counts. The NHLBI describes healthy sleep as having enough hours, good quality, and a regular schedule. You can spend eight hours in bed and still be short on sleep if you wake often or your schedule shifts a lot from day to day.
A quick self-check for the past two weeks:
| Question | Yes | No |
|---|---|---|
| Do I usually get at least 7 hours of sleep? | ||
| Do I fall asleep and wake up at roughly the same times, including weekends? | ||
| Do I wake up feeling mostly rested? | ||
| Can I get through the afternoon without fighting to stay awake? | ||
| Has anyone told me I snore loudly or stop breathing in my sleep? |
More than one “No” on the first four, or a “Yes” on the last one, is worth a closer look with the log below and possibly a talk with your doctor.
Habits for better sleep that support your heart
Mayo Clinic and the NHLBI recommend a similar set of sleep habits. None of them is magic on its own, but together they may help:
- Keep a regular schedule. Go to bed and get up at about the same time every day, weekends included.
- Watch late caffeine, alcohol, and nicotine. Caffeine and nicotine can keep you awake, and alcohol can disrupt sleep later in the night even if it makes you drowsy at first.
- Don’t go to bed very full or very hungry. A large meal close to bedtime can keep you up.
- Make the bedroom dark, quiet, and cool. Room-darkening shades, a fan, or earplugs can help.
- Put screens away before bed. The light from phones and TVs can make it harder to fall asleep.
- Limit long daytime naps. They can make it harder to sleep at night.
- Move during the day. Regular physical activity can help you sleep better, though some people find a hard workout too close to bedtime keeps them up.
- Have a wind-down routine. A warm shower, reading, or quiet music signals that the day is done.
- Get out of bed if you can’t sleep. If you’re lying awake, Mayo Clinic suggests leaving the bedroom to do something relaxing, then going back when you feel tired.
Sleep and heart health by profile
If you work night shifts or rotating shifts
The NHLBI notes that sleeping at the wrong times for your body’s internal clock is a form of sleep deficiency. Keep your sleep times as steady as your schedule allows, make the room very dark during daytime sleep, and protect a full sleep block even on days off. Talk to your doctor if you can’t stay awake on the job or on the drive home.
If you already have high blood pressure or a heart condition
Mention your sleep at every checkup, not only your blood pressure readings. Poor sleep and loud snoring are useful information for your doctor. Our blood pressure readings chart explains how to measure at home, and a morning reading can sit right next to your sleep log.
If you’re in menopause or perimenopause
Night sweats and hot flashes can wake you up repeatedly. A cooler room and light bedding may help. If sleep is disrupted most nights, ask your doctor about options.
If you lie awake with a racing heart
A pounding or fluttering heartbeat at bedtime is often linked to caffeine, alcohol, stress, or simply noticing your heartbeat more when it’s quiet. Our guide to heart palpitations covers common triggers and when to get checked.
A 2-week sleep log for you and your doctor
Fill this in each morning, and keep it for 14 days. It takes about a minute. If you also track your resting heart rate, add a column for it.
| Date | Bedtime | Wake time | Hours slept (estimate) | Times woke up | Caffeine or alcohol after 2 pm? | How rested (1 to 5) | Notes (snoring, naps, stress) |
|---|---|---|---|---|---|---|---|
| Example: Mon | 11:30 pm | 6:30 am | About 6.5 | 2 | Coffee at 3 pm | 2 | Partner says I snored loudly |
| Day 1 | |||||||
| Day 2 | |||||||
| Day 3 |
Keep adding rows through Day 14. At the end, look for patterns: short nights on certain days, late caffeine, or a “rested” score that stays low even with enough hours. That last one is a reason to talk to your doctor.
Snoring, gasping, and other sleep signs to raise with a doctor
Sleep apnea is a condition in which breathing stops and starts repeatedly during sleep. The NHLBI notes that untreated sleep apnea can raise the risk of high blood pressure, heart disease, stroke, and irregular heart rhythms. Many people don’t know they have it, because the signs happen while they’re asleep.
Ask your doctor about sleep apnea or another sleep problem if you have:
- Loud snoring, especially with pauses in breathing that a partner notices
- Gasping or choking that wakes you up
- Heavy daytime sleepiness, like dozing off while reading, watching TV, or driving
- Morning headaches or a dry mouth on waking most days
- Trouble falling or staying asleep that lasts for weeks and affects your days
Some situations need urgent care. Call 911 if you wake with chest pain or pressure, severe shortness of breath, or signs of a stroke such as sudden numbness on one side, trouble speaking, or a drooping face. Also see a doctor promptly if you wake up short of breath and need to sit up to breathe, or if you need more pillows than before to breathe comfortably.
Never drive when you’re struggling to stay awake. Pull over somewhere safe.
Tonight’s sleep step for your heart
Pick a wake-up time you can keep every day for the next two weeks, including the weekend, and set an alarm for it. Count back 7 to 8 hours and put a reminder on your phone 30 minutes before that bedtime to start winding down. Tomorrow morning, fill in the first row of your sleep log.
While you’re paying attention to your body at the end of the day, take a look at your feet and ankles too. Our guide to swollen ankles and feet explains which kinds of swelling are everyday and which are worth a checkup.
