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Sleep difficulties, daytime sleepiness, and health-related quality of life in patients with chronic heart failure
Linköping University, Department of Medicine and Care, Cardiology. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Care, Cardiology. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0002-4259-3671
Linköping University, Department of Medicine and Care, Cardiology. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0001-6353-8041
Department of Nursing, Lund University, Lund, Sweden and School of Social and Health Sciences, Halmstad University, Halmstad, Sweden.
2004 (English)In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 19, no 4, 234-242 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Normal sleep changes with age in duration, fragmentation, and depth. The prevalence of insomnia is high in the elderly general population. In patients with chronic heart failure (HF) objective sleep assessments have shown disturbances such as a shorter total duration of sleep, frequent arousals, and sleep stage changes.

OBJECTIVE:

To describe self-assessed sleep difficulties, daytime sleepiness, and their relation to health-related quality of life (HRQOL) in men and women with HF, as well as to make a comparison to data from a norm population.

METHODS:

Cross-sectional design including 223 patients with HF, New York Heart Association classification II-IV, assessed using the Uppsala Sleep Inventory-Chronic Heart Failure, the Epworth Sleepiness Scale, Medical Outcomes Study 36-Item Short Form Health Survey, and Minnesota Living With Heart Failure Questionnaire.

RESULTS:

The most commonly reported sleep difficulties were initiating and maintaining sleep. The ratio of habitual sleep to the amount of estimated need for sleep was significantly shorter for women (P < .05), and the number of awakenings per night was significantly increased for men (P < .001). A total of 21% suffered from daytime sleepiness. Patients suffering from difficulties maintaining sleep, initiating sleep, and early morning awakenings reported significantly lower HRQOL in almost all dimensions of the SF-36 (P < .05-P < .001) compared to patients without sleeping difficulties, as well as to the normal population. The disease-specific Minnesota Living With Heart Failure Questionnaire showed significantly reduced (P < .05-P < .001) HRQOL as measured by the total and subscale scores for patients suffering from sleeping difficulties compared to patients without sleeping difficulties.

CONCLUSION:

Patients with HF have a reduced HRQOL especially if difficulties maintaining sleep, initiating sleep, and early morning awakenings are involved.

Place, publisher, year, edition, pages
2004. Vol. 19, no 4, 234-242 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-24308PubMedID: 15326979Local ID: 3931OAI: oai:DiVA.org:liu-24308DiVA: diva2:244625
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2017-12-13
In thesis
1. Sleep and health-related quality of life in patients with chronic heart failure and their spouses: a descriptive and interventional study
Open this publication in new window or tab >>Sleep and health-related quality of life in patients with chronic heart failure and their spouses: a descriptive and interventional study
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The general aim of this thesis was to describe and compare the sleep situation and health-related quality of life in patients with chronic heart failure and their spouses, as well as to evaluate the effects of an intervention with 3-months ofhome based oxygen treatment. Descriptive designs were used to describe how patients with chronic heart failure conceived their sleep situation (I), decisive situations that influenced spouses' support to patients with chronic heart failure in relation to the couple's sleep situation (II), and self-assessed sleep difficulties, daytime sleepiness and their relation to health-related quality oflife in men and women with chronic heart failure, as well as to make a comparison with data from a norm population (III). An interventional design was used to determine the effects of 3-months of home based oxygen treatment regarding both subjective and objective outcomes (IV).

Daily life, the disease itself and cardiac symptoms influenced the sleep situation and led to ensuing effects, such as fatigue, listlessness, loss of temper, loss of concentration, a need for daytime sleep, seclusion, information and counseling. Patients handled their sleep disturbances by means of support from their psychosocial environment as well as coping mechanisms related to developed patterns of daily life (I). Decisive situations inhibited or stimulated spouses' support to patients with heart failure, in relation to the couples' sleep situation (II). Self-assessed sleep difficulties such as difficulties initiating sleep, difficulties maintaining sleep, and excessive daytime sleepiness were common in patients with chronic heart failure and gave a decreased health-related quality of life compared to chronic heart failure patients without sleeping difficulties (III). Sleep disordered breathing, with a dominance of central sleep apnea was a very common problem, with a high prevalence, but patients suffering from objectively registered sleep disordered breathing did not show decreased health-related quality of life compared to chronic heart failure patients without sleep disordered breathing. A long-term intervention with nocturnal home based oxygen improved functional exercise capacity for both the whole group of patients with chronic heart failure, as well as in patients with chronic heart failure where sleep disordered breathing occurred. The intervention did not give any persistent improvements regarding cardiac function, objective sleep, subjective sleep, sleep disordered breathing, or healthrelated quality of life (IV).

Sleep disturbances are a complex situation where sleep disordered breathing can be seen as one possible organic trigger, together with psychosocial, as well as environmental factors causing a chain reaction with disturbed sleep, daytime sleepiness and decreased health-related quality of life that leads to physical, social, and mental consequences and needs. Further studies are therefore needed from a holistic perspective on both patients with chronic heart failure and their spouses.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2004. 70 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 836
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-23506 (URN)2970 (Local ID)91-7373-807-7 (ISBN)2970 (Archive number)2970 (OAI)
Public defence
2004-03-04, Aulan, Hälsans Hus, Hälsouniversitet, Linköping, 09:00 (Swedish)
Opponent
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2012-10-29Bibliographically approved

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Broström, AndersStrömberg, AnnaDahlström, Ulf

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