Insomnia and chronic heart failure

Heart Fail Rev. 2009 Sep;14(3):171-82. doi: 10.1007/s10741-008-9102-1. Epub 2008 Aug 29.


Insomnia is highly prevalent in patients with chronic disease including chronic heart failure (CHF) and is a significant contributing factor to fatigue and poor quality of life. The pathophysiology of CHF often leads to fatigue, due to nocturnal symptoms causing sleep disruption, including cough, orthopnea, paroxysmal nocturnal dyspnea, and nocturia. Inadequate cardiac function may lead to hypoxemia or poor perfusion of the cerebrum, skeletal muscle, or visceral body organs, which result in organ dysfunction or failure and may contribute to fatigue. Sleep disturbances negatively affect all dimensions of quality of life and is related to increased risk of comorbidities, including depression. This article reviews insomnia in CHF, cardiac medication side-effects related to sleep disturbances, and treatment options.

Publication types

  • Review

MeSH terms

  • Fatigue / etiology*
  • Heart Failure / complications*
  • Humans
  • Hypnotics and Sedatives
  • Kentucky / epidemiology
  • Quality of Life
  • Sleep Initiation and Maintenance Disorders / complications
  • Sleep Initiation and Maintenance Disorders / drug therapy
  • Sleep Initiation and Maintenance Disorders / epidemiology
  • Sleep Wake Disorders / complications
  • United States / epidemiology


  • Hypnotics and Sedatives