Difficulty falling asleep, staying asleep, or achieving restorative sleep. Sleep disturbance is extremely common following cardiac arrest and trauma, and affects both survivors and co-survivors. Causes include hyperarousal, anxiety, nightmares, intrusive thoughts at bedtime, and the physiological effects of critical illness and its treatment. For ICD patients, fear of a nocturnal shock — or, for Brugada syndrome patients, awareness that arrhythmias are more likely during sleep — can make bedtime particularly anxiety-provoking. Poor sleep significantly worsens mood, cognitive function, and physical recovery. Sleep hygiene measures (consistent sleep and wake times, limiting screens before bed, reducing caffeine) can help, as can addressing the underlying anxiety or trauma through psychological therapy. Persistent sleep disturbance should be discussed with a GP.
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