“Problems Sleeping After Heart Valve Surgery?” Asks Jenny

I just received a great question from Jenny about sleep after heart valve surgery.

Jenny writes, “Adam, I had mitral valve replacement seven days ago for regurgitation. I’m struggling a bit as I deal with the some of the post-operative challenges you address in your book. I’m really having an issue getting a good night of sleep. Sleeping at the hospital was tough enough. But, it’s gotten worse since I came home. I feel like a Zombie. And, the night sweats continue. Is this common? Thanks, Jenny”

Over the years, I have spoke many patients – especially tummy sleepers – that have expressed several sleep problems following heart valve surgery. Some of those problems include:

  • Inconsistent sleep, waking up often
  • Insomnia
  • Night sweats
  • Discomfort getting in and out of bed
  • Heart pounding noises
  • Mechanical valve replacement clicking

Finally, some patients may have an adverse reaction to medication intended to enhance sleep. Personally, I had a very, very, very strange reaction to Ambien. One night, after taking a 10mg Ambien pill, Robyn (my wife) found me sleepwalking through our house. When Robyn approached me, I responded to her as if I was a character in a book that I was reading. When I woke up the next morning, I had no memory of the episode. Needless to say, that was the last time I took Ambien.

Sleepwalking After Heart Surgery

As many former patients read this blog, maybe they can share their thoughts on this topic. Did you experience any problems sleeping after heart valve surgery?

I hope this helps Jenny (and perhaps you) learn more about sleep after heart surgery.

Keep on tickin!

Adam Pick
Written by Adam Pick

Adam Pick is a patient, author of The Patient's Guide To Heart Valve Surgery and the founder of HeartValveSurgery.com.

To learn how Adam has helped millions of people with heart valve disease, watch Adam's video, subscribe to his free newsletter, or visit his Facebook, or Twitter pages.

  • Stephen Waxman

    I have had two aortic valve replacements and the issue of sleeping arose in both cases. I elected not to take sleeping medication the first weeks I was home from the hospital. I continued to take my pain medication and found after about 1 month at home I began to have more regular sleeping patterns. I did not suffer from night sweats. I would advise patience.

    Stephen Waxman

  • Robin Hirsch

    For the first 3 weeks I woke up every 2 hours to the minute, so I developed a routine. I would get up, walk around the house, go to the bathroom if I needed to, get back in bed, read for a few minutes, then go back to sleep. I found that going with it and accepting it, helped me relax rather than fighting it and getting upset which only prolonged the sleeplessness. Since you are not going anywhere the next day, it doesn’t really make any difference what time you wake up. Also, avoid taking too many naps. I would take one in the early afternoon for about 10 minutes. Eventually, your normal sleep schedule will reassert itself. Let nature work, avoid sleeping pills if you can.

    Robin

  • Don Hull

    Hi Jenny,
    I had mitral valve replacement due to regurgitation in April of this year. I had quite a bit of discomfort getting in and out of the bed, especially during the first week home from the hospital. I used pillows not only for coughing but also to help me achieve a comfortable position. Once I found a comfortable position, I was usually able to sleep for at least 6 hours without waking. I had had a bad experience with the strong medications at the hospital (I hallucinated-saw an orange pig eye looking at me through a window…3 times!) and wanted no more of that, so the strongest thing I took at home for pain and as a sleep aid was Tylenol PM. I am a back sleeper so usually I propped my upper torso and head up slightly to get comfortable.
    Take it one day (and night) at a time. You will gradually get better, and the sleep you long for will become more routine. Congratulations on your progress so far. You are well on your way to full recovery!
    Best wishes and good fortune!
    Don

  • Cynthia

    My husband had his mitral valve repaired almost 8 weeks ago. Based on his experience you sound “normal”. He was so looking forward to coming home from the hospital where he could finally get a good night’s rest only to not have that be. It took about a full week for him to have his mind turn off at night as well as his body to get comfortable enough in bed for him to sleep well. I will add that after three nights of not sleeping I called the cardiac surgery department and they suggested he take Bendryl to help him fall asleep. We tried that about an hour before he went to bed and that really helped settle him down to be able to “turn his brain off”.

    Not to worry, your restful sleep will return, just give it time.

  • Marina Dragut

    I had one heart valve replaced with mechanical valve , I had aortic valve repaired, also I had huge blood clot removed.

    All happened 3 months ago.

    Sometimes I can hear my mechanical valve clicking. If some young people are around me, they can hear this clicking too – even when I am not hearing it, hehe.

    Very strange. When I comeback home after the hospital, I had a problem, fell asleep. I didn’t want to take any sleep aid medication, but I did try Tylenol PM for a few days and it helped me, and now I am fine. When I sleep on the left side , I can hear my heart is pounding very hard.

    Also, I have night sweats almost nightly.

  • Andrew Wrigley

    7 days? You are doing well.

    I didn’t sleep for 3 days, but a mild sleeping pill sorted it all out.

    But give it time. At day 7 I was low on potassium and high on just about everything else, including being alive. 3 months later life is great.

    But during the first seven days I had severe episodes of confusion, but only when they moved me from ICU to observation hub to a room on my own.

    Having had endocarditis on my mitral valve, I am terrified of night sweats. They were one of the main symptoms that alerted me to the endocarditis. Might be worth mentioning it to the registrars on the ward.

    Andrew

  • Anita Devine

    Hi Jenny,
    I heard lots of stories about sleeplessness prior to having Mitral Valve Repair. I decided to develop a plan. I downloaded a very relaxing CD on progressive relaxation, into my MP3 player, and if I woke up I got out of bed, went out and laid on the couch, looked out the window at the night sky, and played that CD. I was never awake more than 30 minutes, and the relaxation helped tremendously. I also knew that sleeping during the day produced restlessness at night, so I cut back on the day time naps. After about 2 or 3 weeks, the pattern of waking up disappeared.
    Take care, and be gentle with yourself,
    Anita

  • Andrew Hightower

    Hi Jenny,

    This is how I explained it to my friends and family.

    “It takes me 12 hours to get 6 hours of sleep”

    Good luck with your recovery.

  • neil kortie

    Hi jenny,

    I hope you’re feeling well. I had an aortic valve replaced on May 18 of 2009 and I too could not sleep. This lasted for about 6 to 8 weeks. In that time i was only getting aout 3 to 4 hours of sleep per night. After a couple of weeks I resorted to sleeping on the couch. I found it much more comfortable than my bed, and if I could not fall asleep I could watch TV and not disturb my wife. Also a bowl of cereal seemed to help (figure that one out?). The good news is that you’ll be getting better each day and you’ll be getting a full nights rest in no time.

    Best Regards, Neil

  • Roulla Christoforou

    Hello Jenny,

    I had mitral valve repair on the 24th of August and I am experiencing the same problem, I cannot sleep.

    I end up taking a sleeping tablet but it does not always work as I am taking so much medication at the moment. Also when I wake up the sleeping tablet leaves me with a very bitter taste in my mouth which lasts for hours.

    The taste is so bad that I have the need to throw up and it stops me from being able to eat.

  • George Denning

    I agreed to double vessel bypass and a mitral valve replacement on August 6 here in England. The waiting list is 3 months, so it won’t be until November. However the intense night sweats from the head that I have had all year are increasing. Is this a common feature of my condition? I have searched high & low and got no answers from doctors. Information from anywhere would be a great step forward. (I have not had a consulation with my cardiologist since last December – as is the way in England……….)

  • Tony Korwin

    I too had some issues with sleeping and night sweats.. in fact one night, I was sweating AND it was cold, so I was shivering.. its been 3 months, and I still have the issues sleeping.. I have settled on 1mg Melatonin (lowest dose available) about a 1/2 hour before I want to go to sleep. carries me through the entire night, but doesn’t leave me haggared in the morning. melatonin is the natural breakdown of seratonin that the body produces during daylight hours.. it is meant to help you sleep.

  • Jack Seavy

    I had a terrible time sleeping. I had aortic valve surgery and physically did fine.
    Sleeping and psychiatric issues were the biggest problems I had. Part of it was pain but most of it was emotional. I thought being at home would help but it didn’t. I spent about six weeks pretty miserable and finally sought help. I could exercise like a nut but couldn’t sleep much at all. Counseling, medication, guided imagery and yoga helped me a great deal. Don’t give up as it will get better. Don’t wait as long as I did to deal with the problem and seek help. Six months later I am really good, but initially I was a wreck. After all you are alive and that in itself is a miracle. Be good to yourself and keep going.

  • Don Henry

    I had my aorta valve replaced in 2000 with a bovine tissue valve and yes, insomnia was a big issue for me and still is. I need a sleep aid today. I have never been depressed in my life until this surgery and this too was a big problem for me. This lasted about 6 months , which is normal after undergoing open heart surgery. I was 55 and now 65 and will need another surgery within a year, so this tissue valve only last about 10 years. The hardest decision I think one has to make is which valve to get , mechanical or tissue. I would love to receive info on the best mechanical out now. I certainly do not want to go through 3 surgeries.

  • Nancy Scharf

    I had a mitral valve replacement 7/20/2001. When I was home from the hospital following, I could not sleep through the night. I might sleep for 4 hours maximum. After 1 year, my cardiologist suggested a pacemaker was needed. This gave me more energy; however, I still could not rest during the night. It seemed I only half-slept. I also was like a zombie, with no energy to walk as needed. I finally asked for aid in sleeping and was prescribed Restoril (15 mg) as needed. This has been a Godsend. I sleep a full 6 hours, or maybe up to 8 hours. I am rested and ready to start my day. The majority of the time I am awake by 6:30 a.m. I know it is not what the doctors prefer. However, I feel really good. I also have stenosis of the aortic valve and feel my rest is also very important. I have wondered if other valve recipients have suffered this insomnia. I have made many attempts to break this need for sleep aid, and have always ended up completely worn out.

  • Midge

    Jenny, I’m a number of months after aortic valve replacement. Didn’t have problems sleeping but found a simple trick to help me fall asleep. I have a clock with second hand close to my bed and have found if I lay in a comfortable position and take my pulse at my wrist, counting the beats as the second hand goes around, I fall asleep pretty quickly. Hardly ever make it for a full two minutes. Sometimes I start to nod off but make myself wake up enough to keep counting until I fall fully asleep. Corny but it works.

    To Don Henry, I got my St. Judes Mechanical Valve in Feb. 09 at age 67 for the same reason you state….I didn’t want to face another surgery in 10-20 years. The St. Jude Mechanical is the “gold standard” of mechanical valves and I have yet to hear one click from it. I did have some louder than normal sounding heartbeats for the first 4-6 weeks after surgery but they went away after things got a little more settled internally.

    Midge

  • Lee Samsel

    Had the same problems with sleep and was given Ambien which helped me sleep all day and night and better during the day the Ambien hangover was too much so I switched to Calms Forte it works better for me than the Ambien did and no hangover

  • Rosie

    Hi all, 11 months after mitral valve replacement, I am still sleeping 2/3 of the time on the sofa. My ribs have never completely healed from the open heart surgery, and getting comfortable in bed is extremely hard. Being propped up at the end of the sofa, and sort of wrapping myself like a mummy helps. I only get 6 to 7 hours of sleep nightly and work full time, so I get really tired. I too had the hallucinations on the meds when home from the hospital. I will try the tylenol PM more frequently to see if that helps. My doctor said it could take up to 2 years for the ribs to completelty heal. I keep extremely busy, and am not depressed, just tired !!

  • Steve McDonald

    hi,

    exptecting my surgery in Nov. meet my Mayo team on the 23rd. I am a side sleeper, how long will it be before I can do this? As far a sleep time, I am a toss and turner and don’t really remember ever getting a solid 8 hrs sleep. so whatever sleep I get shouldn,t be much different. Trying to sleep for periods of time on my back will be the challenge.

  • James Nagy

    To respond to Don Henry’s questions, I just had my aortic valve replaced on July 16, 2009 with the On-X mechanical valve by Dr. Ray Singer at Lehigh Valley Hospital in Allentown PA. I chose this valve over tissue valves because of 1) its longevity (forever) and 2) the clinical trial now underway which may prove that On-X valve recipients can look forward to reduced anticoagulant therapy in the near future. I a 50 year old male in good health. I usually don’t hear my valve during the day but I do hear it at night in bed. At first it was a little annoying but have gotten used to it. I too have had night sweats and disturbed sleep in the form of dramatic, fantastic dreaming. I also have not been able to sleep on my sides until this week (11 weeks post surgery). The dreams have calmed down and the night sweats seem to be going away. I determined not to take any sleep aids as I wanted to be drug independent.

    Last weekend I participated in a 3+ mile hike with an elevation rise of 700 feet at a church men’s retreat. This is just a warm up to better things ahead. I am very happy with the On-X valve.

  • Shannon

    I just had aortic aneurysm repair in May. Sleeping was the most difficult thing to accept. It is uncomfortable, and just face it, it HURTS! If you can sleep in a sitting position for part of the night, it may help. It will get better and I know that seems so far away, but just be positive.

    As for the night sweats….I had them at the hospital and after I got home. My surgeon told me it was completely normal. Your body just went through a lot of trauma and is trying to adjust back to its “normal” way of working. It takes a little time, but these quick changes in temperature will also go away!

    You are doing awesome and just remember to take it day by day….actually minute by minute! =)

  • Goose

    Hi all,

    I’m now 16 days and ticking from having a St Jude valve used to replace my congenital bicuspid valve. Since I only needed the valve I had a mini incision and the chest pain and incision are doing just fine.

    I’m sitting here writing this after getting only 45 minutes sleep last night. I’ve had two nights like this. The rest I’ve mananged to sleep pretty well in a big soft reclining rocker I have for 4 to 6 hours. I think the reason I’m not sleeping now is that the Vicodin is now off my list because the resultant constipation almost killed me! I have taken low doses of Vicodin for years because of chronic arthritis pain but having this side effect while still weak is not worth the pain killing. Beware!

    So far, the noise of this thing is driving me mad. I’m hoping it will get better as the earlier posts suggest. I’ve slept on my sides for years and NEVER could sleep on my back. Now, the only quiet spot is on my back and semi-inclined. I’ll consider the Tylendol-PM or Benedryl tricks. Thanks for those ideas.

    If you try to use MP3 music or audiobooks to cover it up for a while, I suggest full over the ear headphones. For some reason earbuds just don’t do it.

    Another oddity I’ve seen. If I am on my side, I can either grab my neck with a hand and squeeze just a little or jam a pillow there and the noise almost stops! I guess I still need blood to my brain but I find this sort of amusing.

    My naturual bed time the last few months before the surgery was 1:30 am so I guess I don’t worry much if it gets to 2 or 2:30 and I don’t sleep…. but when it gets to 4 am one of two things happens. I either fall asleep and don’t wake up until 9:30 or I just stay up.

    Keep up the great posts. Sharing information really helps deal with this.

    goose

  • Dave Farmer

    I’m 4 weeks after aortic replacement and mitral repair. Physically, I’m progressing – 30 minutes on treadmill at 3.5 mph or ellipiictal. Stopped pain meds last week, but having problems sleeping. Going to bed @1AM like noirmal, can’t sleep, @ 3AM, I take prescribed Ambien 10 mg., which gives me @ 3-4 hours of sleep.
    Being an alcoholic and going through DT physical withdrawl 2 days post-op in the hospital, I’m wondering if the withdrawl is still a factor with sleep difficulties.
    AA couselors said once through DT’s most problems are abstinance and psychological. Then, my GP also said fever may occur and it ended 2 weeks ago. He prescribed the Ambien.I’d appreciate any info. from anyone with similar post -op sleep problems and an alcoholic

  • Harlan

    I had triple by pass and aortic valve replacement about six weeks ago. Doing great, feeling fine. except about two weeks ago I started to have night sweats,a couple times a night. Does anyone know how long they will last. this is the only thing preventing me, from having a good night sleep.

  • sally L

    i can hear my valve clicking too. I find it quite un nerving so i have some podcasts on my ipod shuffle and i listen to that until i go to sleep. It does not matter if i dont hear the end of the podcast, i can start it again the next night. i only had my surgery 3 weeks ago.

  • Thomas Boak

    Just had mitral valve and aortic ventrical valves replaced 7 weeks ago. Still can’t sleep because of the ‘ticking’ of the valves. They are driving me crazy. I am exhausted, frustrated and depressed. I get up at night and listen to music on my head set and hope to fall asleep in my chair. My wife is trying to be understanding, but it is hard on both of us. Any help? How have others dealt with this? Thanks.

  • Nicci

    Hey

    i had my mitral valve replaced with a tissue valve. I also ended up needing a pacemaker… i couldn’t wait to get home to my normal bed, but now i have a hard time falling asleep, and when i do i wake up with my bed soaked in sweat. Adivan doesn’t work anymore to help me sleep, and i never used to sweat so much in my sleep… when will it all go away? or what can i do to help me fall asleep earlier and sweat less?

  • Mike

    I had 3 bypass in 04 ever since can’t sleep on either side have sleep flat of back. Like to know why this happen?

  • david

    I had av valve surgery 7 to 8 days ago and cannot sleep.

  • frank

    I had the aortic valve replaced(st. jude mech) and the ascending aorta repaired(aortic aneurysm) 4/28/10. That was also my 70th birthday. I still hear the ticking when I first go to bed. I am a restless sleeper by nature. I have found that sleeping on my back with my hands folded on my chest lessen the ticking. I still sleep on my side but sleeping on the right side causes the loudest ticking. Other than the ticking, I have had no problems. I returned to playing golf 4 or 5 days a week 3 months after my surgery. I am still play golf on a hilly course that I walk with an electric push cart. I am doing many of the things I did before the surgery.

  • nicci

    after getting some sleeping pills from my doctor i was able to finally start getting some sleep. When you first come home from the hospital it’s nearly impossible to get a good night’s rest, but give it some time and it does get better. My surgery was in march and its sept now and i feel 100% better.. no more night sweats or chest discomfort.. just hang in there..

  • Jonathan

    I had my aortic valve replaced about a month ago and sleep is very hard to come by. I am 23yrs old and am a very active person who doesn’t like to stay in one place too long. I get very tired at night but when I lie down it’s like my body says “nope, time to get up” so I stay dugged at night on a sleep pill.

  • Mel

    I am day9 after aortic valve replacement. I have averaged 5 hours sleep per day but do not feel over tired. My discomfort when lying down has not stopped in any position. Naps are great. I have not been talking sleeping pills at home as I am to afraid to try my usual stomach sleeping.

  • Teresa

    I had open heart surgery three months ago. I tried sleeping on my side but it hurts when I do. And then the next day my chest is sore to the touch. Could I have bent the wires that are holding the bone together?

  • claire codd

    my daughter had a heart valve done 1 wk ago it is a machanical one and she has come home today.when putting her into bed we could hear a clicking noise what is this does anyone know .she is fine in her self but the noise is loud .

  • joey

    I had an aorta valve replacement and an aneurysm repaired on March 1 2012,,,,, Man I am having a hard time sleeping… I don\’t think I have had more than 1 night that I actually had a good nites rest.. My chest is feeling much better but I do stretch it regularly. I guess time will take care of the sleeping …. I have tried Tylenol pm but it really didn\’t work that good for me… Hope you all recover quickly and have a very healthy and prosperous life……

  • Greg Duffy

    Had Mitral Valve repair surgery nearly 4 weeks ago and doing fairly well, not sleeping that good but may have to cut out daytime naps. Exercise as presribed by physios is a must and I start rehab this week. Have found daily walking really beneficial but if I walk too fast or too long, I do feel a little tired for half a day. I am doing 1.5-2 ks a day

  • Renee Cooper

    I had an aortic heart anuerysm Jan 18, 20012 and I have not experienced a good noghts sleep sense my surgery. I have a paralyzed left diaphgramas a result of the surgery which makes sleeping on my back impossible! the night sweats started the night I finally came to after 5 days in ICU. I have also expeienced the night swaets each night. I spent three months in cardiac rehab. I am 36 and had never been ill that much a day in my life-the worse I ever expeience was the flu. My life has totally changed since Jan.18- I had three tears to my aorta. My energy level is about 60% Can anyone relate to my story?

  • Frank Fitzgerald

    I had a mechanical mitral valve replacement 10 days ago and have had heavy night sweats the last 2 nights. I’ve read it might be due to late after affects of the anesthesia. Your explanation above also makes sense.

  • James AK

    Had mitral valve replacemnt surgery (mechenical valve) in october 2009. i am just fit as normal man. i am 24 years old now. the only problem is the loud clicking sound. i just cant sit near someone as they note the sound. i just sick of such situation. my wife also try to understand the situation but i just become a psychy patient due to this. what would be she thinking about me and about this situation. i love her and she loves me i think but what other people would be thinking that her husbd is a heart patient :(

  • James AK

    and Thomas Boak what is your age??? I have the same problem you have

  • Max

    Hello!
    I know it’s a bit late but I had a pulmonary valve replacement at the beginning of last year. For the first few days after surgery I was fine sleepwise I was so drugged up. On the fourth night when medication started to wear of I began to have trouble sleeping, no matter how hard I tired I was I simply couldn’t go to sleep. Combine this with the pain everytime you move and hot sweats even though it was cold I was very uncomfortable! For then next 3 days I had no sleep at all even though I was exhausted. I would lie in bed tossing and turning (painfully) and had night sweats. Eventually I could get to sleep but i still experienced night sweats and discomfort.

  • Mayri

    Well it’s 5am, a month after my 2nd aortic valve replacement and I finally got smart enough to look and see if I wasn’t alone. Normally I am known for my ability to pass out in front of the TV or reading. But I have horrible insomnia now. It doesn’t seem to matter what I try… Pain pills, no pain pills, Benedryl, none, relaxation, meditation, etc. etc. I just can’t go to sleep usually till about 6-8 am and then for 4-5 hours on not great sleep. The good news is I’m alone which actually does help. I do know it will end at some point. But it’s making recovery take longer. It’s funny, someone else said something like this, but I do feel like my heart does kind of keep me awake. It is quieter than my last one, especially at the end, and I don’t have the pain I had there, but it is not a mild heartbeat either. Kind of bumpy for lack of a better word.

    Anyway, thanks to others for writing. It helps to know I am not alone. By the way I also can not, in any way lay down yet. I can only sleep sitting in easy chairs laid back at most. I’d kill to sleep on my side… But have to wait for that.

  • Steve Tingler

    Before my aortic mechanical valve was implanted 3 yrs ago I hardly ever had dreams if I did I didn’t remember them. Now after my implant I have dreams every night they seem so real I usually don’t feel like I get a good nights sleep. Anyone have this problem?

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