Insomnia and chronic heart failure

Hayes, Don; Anstead, Michael; Ho, Julia; Phillips, Barbara

doi:10.1007/s10741-008-9102-1

Cited by 57 publications

(48 citation statements)

References 62 publications

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“…AHI ≥ 15 in patients with LVEF ≤ 40%) and the 48% found by Oldenburg et al 1 and Damy et al, 37 respectively. SDB-related breathing events have in previous studies been found to cause a disturbed sleep structure, with increased arousals, 38 insomnia, 39 and daytime sleepiness. 3 We found that patients with SDB had more difficulties maintaining sleep compared with those without SDB (76% vs. 60%, P , 0.05), but the sleep and wake pattern, as well as insomnia variables, did not differ between the groups.…”

Section: Discussionmentioning

confidence: 89%

Association between sleep‐disordered breathing, sleep–wake pattern, and cognitive impairment among patients with chronic heart failure

Hjelm

Strömberg

Årestedt

et al. 2013

European J of Heart Fail

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AimsChronic heart failure (CHF) and sleep-disordered breathing (SDB) are often co-existing problems among the elderly. Apnoeic events may cause cognitive impairment. The aim of the study was to compare sleep and wake patterns, insomnia, daytime sleepiness, and cognitive function in community-dwelling CHF patients, with and without SDB, and to investigate the association between sleep-related factors and cognitive dysfunction. Methods and resultsIn this cross-sectional observational study, SDB was measured with an ApneaLink device and defined as an apnoeahypopnoea index (AHI) ≥15/h of sleep. Sleep and wake patterns were measured with actigraphy for 1 week. Insomnia was measured with the Minimal Insomnia Symptom Scale, daytime sleepiness with the Epworth Sleepiness Scale, and cognitive function with a neuropsychological test battery. A total of 137 patients (68% male, median age 72 years, 58% NYHA functional class II) were consecutively included. Forty-four per cent had SDB (AHI ≥15). The SDB group had significantly higher saturation time below 90%, more difficulties maintaining sleep, and lower levels of daytime sleepiness compared with the non-SDB group. Cognitive function and sleep and wake patterns did not differ between the SDB and the non-SDB group. Insomnia was associated with decreased global cognition. ConclusionThe prevalence of cognitive dysfunction was low in this population with predominantly mild to moderate CHF. This might have influenced the lack of associations between cognitive function and SDB. Insomnia was the only sleep-related factor significantly influencing cognition.--

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Section: Discussionmentioning

confidence: 89%

Association between sleep‐disordered breathing, sleep–wake pattern, and cognitive impairment among patients with chronic heart failure

Hjelm

Strömberg

Årestedt

et al. 2013

European J of Heart Fail

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“…1,2 Melatonin production may be affected by β-blockers; diuretics cause nocturia; and inotropics affect agitation; all of which result in poor sleep quality. 13 In future, functional imaging may be useful to determine the association between HF and insomnia. Functional neuroimaging has shown that transition from wakefulness to sleep is associated with a decrease of brain activity in specific regions, such as the brainstem, thalamus, and prefrontal cortex.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Insomnia in Heart Failure

Kanno

Yoshihisa

Watanabe

et al. 2016

Circ J

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“…CBT-I has welldocumented benefits, including improvements in insomnia, sleep continuity, and daytime symptoms among patients with a number of comorbid medical conditions. [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] CBT-I also may improve sleep for HF patients who dislike the adverse effects of hypnotic medications 12 and are at especially high risk for insomnia and disabling daytime symptoms 34 that are often attributed to HF itself. However, the effects of CBT-I in HF patient have not been examined, and it is not clear that the results of previous studies of CBT-I in people with other chronic medical conditions are generalizable to the HF population.…”

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confidence: 99%

Feasibility and Efficacy of a Self-Management Intervention for Insomnia in Stable Heart Failure

Redeker

Jeon

Andrews

et al. 2015

Journal of Clinical Sleep Medicine

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Background: Chronic insomnia is common among patients with heart failure (HF) and may contribute to fatigue and poor function. However, to date there have been no randomized controlled trials focused on treatment of insomnia or daytime symptoms in this population. Objective: The purpose of this study was to examine the preliminary effi cacy, feasibility, and acceptability of a selfmanagement intervention (cognitive behavioral therapy [CBT-I]) for insomnia among patients with stable HF. Methods: We conducted a pilot randomized controlled trial (RCT) in which patients with stable Class I-III HF (n = 25/52.1% women; mean age = 59 ± 14.8 years) were randomized in groups to CBT-I (n = 29) or an attention control condition (HF self-management with sleep hygiene; n = 19). Participants completed 2 weeks of wrist actigraphy, the insomnia severity index, and measures of fatigue, depression, sleepiness, and functional performance at baseline and follow-up. We computed the size of the effects on the dependent variables and used MANOVA to evaluate the effects of CBT-I on insomnia and fatigue. Results: CBT-I was feasible and acceptable and had a statistically signifi cant effect on insomnia and fatigue, while controlling for the effects of comorbidity and age. Conclusions: CBT-I has short-term effi cacy as a treatment for chronic insomnia among patients with stable HF. Future studies are needed to address its sustained effects. Keywords: self-management, heart failure, insomnia, cognitive behavioral therapy, sleep, fatigue, depression Citation: Redeker NS, Jeon S, Andrews L, Cline J, Jacoby D, Mohsenin V. Feasibility and effi cacy of a self-management intervention for insomnia in stable heart failure. J Clin Sleep Med 2015;11(10):1109 -1119 .pii: jc-00335-14 http://dx.doi.org/10.5664/jcsm.5082 H eart failure (HF), a disabling chronic condition that affl icts over fi ve million Americans, 1 is associated with excess morbidity and mortality, comorbidity, poor daytime function, and high symptom burden. Almost 75% of HF patients report poor sleep.2,3 Insomnia, characterized by diffi culty initiating and maintaining sleep, early morning awakenings, non-restorative sleep, and daytime dysfunction, occurs in 25% to 56% of HF patients, 2-5 who report higher rates than "healthy" controls 2 and the general population. Chronic insomnia contributes to incident HF and death. 6 It is distressing and associated with symptoms, such as fatigue, nocturnal dyspnea, depression, anxiety, pain, and excessive daytime sleepiness, poor quality of life, and decrements in functional performance. 3,5,[7][8][9][10][11][12][13] Health care providers frequently attribute sleep disturbance, including insomnia symptoms, to the pathophysiology (e.g., fl uid congestion) and symptoms of HF itself (e.g., nocturnal dyspnea, nocturia) or to sleep disordered breathing that occurs in about half the population.14 However, sleep disordered breathing does not consistently explain insomnia, self-reported sleep quality, or fatigue; and insomnia was closely associated with...

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Insomnia and chronic heart failure

Cited by 57 publications

References 62 publications

Association between sleep‐disordered breathing, sleep–wake pattern, and cognitive impairment among patients with chronic heart failure

Association between sleep‐disordered breathing, sleep–wake pattern, and cognitive impairment among patients with chronic heart failure

Prognostic Significance of Insomnia in Heart Failure

Feasibility and Efficacy of a Self-Management Intervention for Insomnia in Stable Heart Failure

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