The Study at a Glance | The Study's Findings | Why Sleep Regularity Matters
Overview
Heart failure (HF) is one of the main reasons older adults end up back in the hospital, sometimes just weeks after being discharged.
Despite advances in medications and devices, the transition home after an acute HF hospitalization remains a high-risk period, with many patients facing rehospitalization or worse.[1]
For improved outcomes, clinicians typically focus on things they already know, such as medications, diet, exercise, and other health issues. However, new research reveals that another, frequently neglected factor - sleep consistency, may have a significant effect.
A study by experts from Oregon Health and Science University posed a simple yet powerful question: Does the consistency of patients' sleep schedules after hospitalization affect their risk of complications?
The findings suggest that sleep regularity may have an equal impact on recovery as traditional clinical interventions, presenting a new, low-cost target for care.[2]
Let us explore this fascinating research together.
The Study at a Glance
Oregon Health and Science University researchers, led by Brooke M. Shafer and colleagues, evaluated 32 persons who had recently been discharged from an acute heart failure hospitalisation.[2]
These individuals had been hospitalized at OHSU Hospital and Hillsboro Medical Center from September 2022 through October 2023.
Participants kept sleep diaries for one week after being discharged from the hospital, recording when they fell asleep at night, when they woke up in the morning, and when they took their naps.
Using data from the sleep diaries, the researchers computed the Sleep Regularity Index (SRI), which measures how regularly someone is sleeping or awake at the same periods throughout the day.
The Study's Findings
Regular sleepers were defined as having an SRI of more than 87%, while individuals with lower ratings (less than 87%) were classed as moderately irregular.[2]
After gathering all of the data, the expert analysed the differences between the SRI groups, and the results were telling.
Here is what they found:
- Twenty-one (21) patients had a clinical incident within six months of being discharged from the hospital.
- Of that group, 13 were classed as moderately irregular sleepers, compared to eight who had a regular sleep regimen.
- Statistically, irregular sleepers had more than double the probability of an incident over the six months.
Even when possible contributing factors like sleep disorders and other underlying medical conditions were taken into account, moderately irregular sleepers still had a higher chance of a clinical event.
The study's authors noted that it is one of the first to examine the effects of regular sleep on heart failure. The results add to a growing body of evidence that shows how important it is to stick to a regular sleep routine.
Why Sleep Regularity Matters
Sleep is more than just the number of hours we sleep per night. Experts are increasingly recognising that the timing of our sleep is just as essential.
Irregular sleep interrupts the body's circadian rhythm, which regulates not just sleep-wake cycles but also cardiovascular, metabolic, and immunological systems.[4][5]
Shafer, the study's lead author, said that the results strengthen the link between sleep regularity and heart health.[3]
"When we're asleep and in a resting state, our blood pressure and heart rate decrease compared with daytime levels," Shafer noted.
She goes on to say, "but variability in the time you go to sleep may mess up mechanisms that keep your cardiovascular system in check."
If you already have heart failure, not getting enough sleep daily may make things worse.[3]
"Improving sleep regularity could be a low-cost treatment approach for reducing adverse outcomes in adults with heart failure," Shafer concluded.
The Takeaway
This study emphasises the significance of sleep regularity during the critical months following HF hospitalisation.
Individuals exhibiting moderately irregular sleep patterns had over twice the risk of clinical setbacks, in contrast to those maintaining consistent sleep schedules.
The findings, though preliminary, suggest that regular sleep is a low-cost, attainable goal for enhancing recovery.
Keeping an eye on your sleep rhythm may be just as important for heart failure care as taking your medications.
References:
- Heidenreich, P. A., Bozkurt, B., Aguilar, D., Allen, L. A., Byun, J. J., Colvin, M. M., Deswal, A., Drazner, M. H., Dunlay, S. M., Evers, L. R., Fang, J. C., Fedson, S. E., Fonarow, G. C., Hayek, S. S., Hernandez, A. F., Khazanie, P., Kittleson, M. M., Lee, C. S., Link, M. S., Milano, C. A., … ACC/AHA Joint Committee Members (2022). 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 145(18), e895–e1032. https://doi.org/10.1161/CIR.0000000000001063
- Shafer, B. M., Hiatt, S. O., Kogan, S. A., Lee, C. S., Dieckmann, N. F., Chien, C. V., Denfeld, Q. E., & McHill, A. W. (2025). Effect of posthospitalization sleep regularity on clinical events in adults with heart failure. JACC Advances, 4(9), 102109. https://doi.org/10.1016/j.jacadv.2025.102109
- Oregon Health & Science University. (2025, August 24). Why irregular sleep puts heart failure patients in danger. Science Daily. https://www.sciencedaily.com/releases/2025/08/250824031534.htm
- Sarode, R., & Nikam, P. P. (2023). The Impact of Sleep Disorders on Cardiovascular Health: Mechanisms and Interventions. Cureus, 15(11), e49703. https://doi.org/10.7759/cureus.49703
- Ferreira, R. C. M., Ruiz, F. S., & de Mello, M. T. (2025). Human sleep and immunity: The role of circadian patterns. Handbook of clinical neurology, 206, 93–103. https://doi.org/10.1016/B978-0-323-90918-1.00003-4
