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Sleep in Young Adults with Heart Defects

Ages 18 - 24 Years

Everyone needs enough sleep to stay as healthy as possible. When you have a chronic illness, sleep is even more important for you than it is for other people. Unfortunately, young people with congenital heart defects (CHDs) often have problems getting the right amount of deep sleep. Here are some ideas to help.

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Typical sleep development

Sleep patterns change over the course of typical development. By the time they reach early adulthood, most people:

  • Sleep between 7 and 9 hours a night

  • Wake briefly during the night, and then fall back asleep quickly

  • Get through the day without napping

Many young adults naturally prefer stay awake later at night, and then sleep late in the morning. Unfortunately, this natural schedule often does not work with their school or work schedule.

As young people move through their 20's, they usually naturally start to wake earlier, and want to go to bed earlier.

Sleep needs vary widely from one person to another, so your sleep needs may look different from the general trends. Some heart problems make people very tired, and they may need more sleep. On the other hand, some developmental disorders like autism spectrum disorder (ASD) can be associated with needing less sleep.

You should ask your doctor if you have any questions or concerns about your sleep patterns.

Sleep in people with heart defects

Young people and their families often feel frustrated about sleep. They may worry that a person with a heart defect is not getting enough sleep, is not getting high-quality sleep, or is not sleeping at the right times.

Young people with heart defects may:

  • Have trouble falling asleep

  • Sleep in an unusual place (like a couch, chair, car, or their parent's room)

  • Wake many times during a night

  • Want to eat or drink during the night (even when a doctor says they do not need this)

  • Need certain things in order to sleep (example: another person in the room, a drink, a particular sound or light)

Sleep associations

People often learn to fall asleep under certain conditions. For example, they might learn to sleep when they:

  • Are lying on a couch in front of the TV

  • Have a special blanket

  • Are drinking from a water bottle

  • Are listening to the radio

  • Are in a recliner

  • Are wearing headphones

  • Have a sound machine on

These are called “sleep associations,” because you associate, or connect, certain conditions with going to sleep. Sleep associations are helpful when they are safe, and when they work well with a family’s goals and schedules.


These are called "sleep associations," because you associate, or connect, certain conditions with going to sleep.

When sleep associations are a problem

Sleep associations can be a problem if they:

  • Are not safe

  • Do not meet a family’s goals

  • Disrupt the family’s schedule

  • Make people frustrated or overwhelmed

  • Mean anyone is not getting enough continuous sleep

Sleep associations are problems for many (but not all!) families when:

  • Family members get up and switch beds through the night (“musical beds”)

  • Someone is sleeping in a place that does not work for everyone

  • Someone has to go through a long routine to get back to sleep many times over the night

  • A bedtime routine feels too long and is not pleasurable

  • A person has to eat or drink overnight in order to get back to sleep

Preventing unhelpful sleep associations

Preventing unhelpful sleep associations is easier than breaking ones that are already established.

You can prevent unhelpful sleep associations by making sure you fall asleep in a way that will work for your household long-term.

Remember, if you needs something to fall asleep at bedtime, you will likely need the same thing to fall back asleep in the middle of the night.

You may want to think about:

  • Where you sleep

    • Which room?

    • What kind of sleeping space? (own bed,? shared bed? couch? chair?)

  • Conditions in the room

    • Room-darkening shades?

    • Nightlight?

    • Sound machine?

    • Music?

    • Fan?

    • Humidifier or dehumidifier?

    • Door(s) open or closed?

  • Comfort items

    • Weighted blanket?

    • Body pillow?

    • Hot water bottle?

  • Bedtime routines

    • Reading?

    • Music?

    • TV?

    • Massage?

    • Drink of water?

    • Bath/shower?

    • Meditation?

You should pick bedtime practices that will work for you and your family for months or years.

Changing sleep associations

If you already have an unhelpful sleep association, you can gradually move away from the association. For example:

  • If you are used to rocking in a recliner till you fall asleep, then try rocking till you are very tired and then moving to your bed

  • If you are used to falling asleep in front of the TV and then moving to the bedroom, you could try listening to the audio of a TV show while lying in their bed.

  • If you are used to falling asleep with a light on, try dimming the light little by little over a week

Changing sleep habits can be hard to get used to, and changing them slowly is helpful.

Sleep hygiene

“Sleep hygiene” means the behaviors and conditions that lead to better sleep.

Good sleep hygiene means:

  • Go to bed and wake up at the same time every day

  • Avoid screens before bed

  • Keep the bedroom dark and cool

  • Consider white noise or calming music

  • Use a consistent bedtime routine

  • Save the bed for sleep, not other activities

  • Avoid alcohol, nicotine, and caffeine, especially before bed

  • Get exercise during the day

When the whole family practices good sleep hygiene, usually everyone gets more and better sleep.

Prioritizing sleep

Healthy sleep is critical to your physical and mental wellbeing. You can and should seek help if you are struggling to get enough high-quality sleep.

This content was reviewed by a psychologist at Boston Children's Hospital.

Developmental care is best when it is local. Families local to Boston can receive care from the Cardiac Neurodevelopmental Program (CNP). Families from other regions can use the link below to find their local care team.

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