Sleepless nights and sleepy days: a qualitative study exploring the experiences of patients with chronic heart failure and newly verified sleep‐disordered breathing

Abstract

Background Sleep‐disordered breathing, including obstructive sleep apnoea and central sleep apnoea, is a common disorder among patients with chronic heart failure. Obstructive sleep apnoea is often treated with continuous positive airway pressure, but central sleep apnoea lacks a clear treatment option. Knowledge of how sleep‐disordered breathing is experienced (e.g. difficulties and care needs) and handled (e.g. self‐care actions) by the patients is limited, but needed, to provide patient‐centred care. Aim To explore how newly verified sleep‐disordered breathing is experienced by patients with chronic heart failure. Methods Data were collected through semi‐structured interviews and analysed with qualitative content analysis. Seventeen participants (14 men, three women), mean age 60 years (range 41–80) diagnosed with chronic heart failure and objectively verified sleep‐disordered breathing (nine obstructive, seven central and one mixed) were strategically selected from heart failure outpatient clinics at two Norwegian university hospitals. Results Patients with chronic heart failure and newly verified sleep‐disordered breathing (SDB) described experiences of poor sleep that had consequences for their daily life and their partners. Different self‐care strategies were revealed, but they were based on ‘common sense’ and were not evidence‐based. The awareness of having SDB was varied; for some, it gave an explanation to their trouble while others were surprised by the finding. Conclusion Patients with chronic heart failure and sleep‐disordered breathing experienced reduced sleep quality, influencing their daily life. Possible underlying causes of disrupted sleep, such as sleep‐disordered breathing, should be identified to establish proper patient‐centred treatment strategies. There is a need for new strategies to approach patients with chronic heart failure (i.e. those with central sleep apnoea) who are not subject to continuous positive airway pressure treatment for their sleep‐disordered breathing.

Indicadores Preditivos Da Capacidade De Autocuidado Da Pessoa Idosa – Revisão Sistemática Da Literatura

“…Assim, ficaram elegíveis 7 artigos para extração de dados -processo de seleção na Figura 1. Os indicadores preditivos da capacidade de autocuidado da pessoa idosa que se destacam nos estudos são: doença crónica (Gao et al, 2023;Gullväg et al, 2019;Guzmán et al, 2019); atitude perante a vida (Choi et al, 2021;Gao et al, 2023); rede de apoio social (Choi et al, 2021;Gao et al, 2023;Guzmán et al, 2019); idade (Doroszkiewicz & Sierakowska, 2021;Nagae et al, 2022); deficiência (Doroszkiewicz & Sierakowska, 2021;Gao et al, 2023;Nagae et al, 2022;Qin et al, 2023); e, políticas específicas para idosos (Gao et al, 2023;Qin et al, 2023).…”

“…O estudo de Teixeira et al (2023) teve como população-alvo ≥18 anos, no entanto identificou indicadores preditivos de autocuidado idênticos para a pessoa idosa, tais como a idade, a doença mental e a literacia em saúde. O indicador "doença crónica" surge em três estudos com impacto negativo na capacidade de autocuidado (Doroszkiewicz & Sierakowska, 2021;Gao et al, 2023;Gullväg et al, 2019;Guzmán et al, 2019). Este achado é evidenciado em outros estudos, em que a doença crónica influencia a capacidade para o autocuidado, o que pode condicionar a realização das atividades de vida diária instrumentais (Almeida & Bastos, 2017;Teixeira et al, 2023).…”

Prevalence of chronic pain and chronic widespread pain among subjects with heart failure in the general population: The HUNT study

“…Female sex, depression and anxiety, smoking, sleeping problems, overweight or obesity, and a family history of pain are known risk factors for CWP (Bergman et al, 2002; Kvalheim et al, 2013; Mundal et al, 2014). A high prevalence of sleeping problems, overweight, and depression also characterize patients with HF (Alpert et al, 2017; Gullvåg et al, 2019). Typically, subjects with advanced HF have marked limitations of physical activity (Woolf, 2011) and also subjects with CWP experience difficulties with physical activity (Sylwander et al, 2020).…”

Self-reported Sleep Quality Before and After Atrial Fibrillation Ablation

“…Other researchers have demonstrated how reduced sleep quality can decrease quality of life on a daily basis for patients with chronic heart failure, 31 but this has not been examined in individuals with persistent AF or those undergoing AF ablation treatment. Gullvåg and colleagues 31 point out the need for research to identify mechanisms underlying sleep disturbances that could lead to development of more evidence-based interventions patients could use to better manage the consequences of poor sleep quality in chronic heart failure, and this would also be important to investigate in future for those with AF.…”