Sleep disturbance is one of the most commonly reported problems in cardiac arrest survivors, yet it is often overlooked in clinical follow-up. Difficulty falling asleep, staying asleep, waking early, experiencing nightmares, or feeling unrefreshed despite adequate sleep hours can all significantly worsen fatigue, cognitive function, mood, and quality of life during recovery.
**Types of sleep disturbance reported by survivors**
– **Insomnia:** difficulty initiating or maintaining sleep, or waking significantly earlier than intended
– **Nightmares and distressing dreams:** often related to traumatic memories of the cardiac arrest, ICU experiences, or fears about dying, associated with PTSD
– **Hyperarousal:** the nervous system remaining in a state of alert, making it difficult to relax enough to sleep
– **Sleep apnoea:** disordered breathing during sleep, which is more common in people with cardiac conditions and can worsen fatigue and cardiac function
– **Fragmented sleep:** multiple awakenings, often without clear cause, resulting in poor sleep quality despite adequate time in bed
**Why sleep matters for recovery**
Sleep is when the brain consolidates memories, clears metabolic waste products, and carries out neurological repair. Insufficient or poor-quality sleep impairs cognitive function, emotional regulation, immune function, and cardiovascular recovery. Survivors who sleep poorly typically experience more fatigue, worse cognitive symptoms, and slower overall recovery.
**Management**
The approach depends on the underlying cause:
– Trauma-related sleep disturbance: trauma-focused CBT or EMDR
– Anxiety-related hyperarousal: CBT for insomnia (CBT-I), relaxation techniques, sleep hygiene advice
– Sleep apnoea: referral for a sleep study and possible CPAP treatment
– Medication review: some cardiac and other medications can disrupt sleep
A GP is the appropriate first point of contact.
« Back to Glossary Index