Poor sleep and impaired self-care: Towards a comprehensive model linking sleep, cognition, and heart failure outcomes

Abstract

Background-Persons with heart failure (HF) have significantly lower sleep quantity and quality than persons without HF. The purpose of this article is to propose a conceptual model describing how poor sleep may contribute to inadequate self-care and untoward outcomes in persons with HF.Aims-Our overarching hypothesis is that sleep affects self-care and outcomes through its effects on cognition. Building on the work of others, we outline a conceptual model that illustrates that even transient sleep disruption prevents sleep-related restorative processes and contributes to cognitive dysfunction-especially in the 25-50% of HF patients with existing cognitive impairment. Poor sleep may be sufficient to impair cognition to a level that interferes with higher order functions involved in effective HF self-care practices. Through these mechanisms, inadequate sleep may contribute to poor outcomes such as low health-related quality of life and greater risk of unplanned hospitalization.Conclusion-The proposed model (1) bridges physical, neuropsychological and behavioral phenomena, (2) suggests a mechanism by which poor sleep affects daytime behavior, and (3) is empirically testable. Exploring factors that interfere with sleep may improve self-care and outcomes in persons with HF.

Association of sleep quality and dementia among long-lived Chinese older adults

“…In the present study, participants with poor sleep quality had a higher prevalence rate of dementia, and those with dementia had also a higher prevalence of poor sleep quality. These were consistent with the previous studies (Wu and Swaab 2007;Riegel and Weaver 2009;Rose et al 2010). Although the PSQI is a general measure of sleep quality, participants' responses to various questions can also be used to measure difficulty initiating sleep (latency) and sleep efficiency (percent of time spent in bed that the individual was actually asleep).…”

“…In addition, dementia, sleep complaints, and sleep-related problems are known to increase with age (Wolkove et al 2007a, b;Bastos Leite et al 2004;Plassman et al 2007;Wu and Swaab 2007). Although there is sufficient evidence from humans and experimental animals on the association between sleep disorders and dementia, these topics have not yet been explored in the very elderly population (Rose et al 2010;Riegel and Weaver 2009;Yu et al 2009;Haimov et al 2008;Benito-León et al 2009;Hasan et al 2012). Therefore, it is important to clarify the association between sleep disorders and dementia in this age group.…”

Quality of life and symptoms of depression in advanced heart failure patients and their partners

“…In addition, many patients suffer from pain, anxiety, depression, nausea and constipation (8)(9)(10). Sleeping problems are also common, almost 60% of the HF patients report trouble with sleeping which is related to a poor quality of life (11)(12)(13). More recently the prevalence of pain in HF patients has been addressed (14,15).…”

The Status of Quality of Life and Adaptation of Patients with Heart Failure to Their Disease in Shushtar, Khuzestan Province

“…Incidence and prevalence of heart failure are increasing even in developed countries of the world (2). The hospitalization rate for this disease has increased to twice its original amount in the past two decades (3), and it is now one of the major causes of death (4). In Iran, over one million people are afflicted with heart failure (5).…”

“…Patients with heart failure undergo many problems such as shortness of breath, edema, pain, depression, fatigue, nausea, constipation, sleep disorders and anxiety (7). These problems could affect the activity, abilities, and strength levels of these patients (3). Coping with these debilitating symptoms often causes stress, low self-confidence and reduced quality of life (8), and also imposes a heavy financial burden on health care providers (9).…”