Title : Predictors of sleep disturbance in patients with heart failure
Heart failure is the common final pathway for various cardiac diseases. Despite advances in treatment, the prognosis remains poor with high readmission rates and mortality. Symptomatology has identified as prognostic in nature among heart failure patients. Within the symptom profile, sleep disturbance has received the least attention despite its high prevalence among this vulnerable cohort.
Aim: The purpose of this study was to examine the sleep pattern and quality in heart failure patients, and to identify predictors of sleep disturbance in these patients.
Methods: Chinese community-dwelling adults (N = 80) with a confirmed diagnosis of heart failure were recruited in the cardiac clinics of two regional hospitals in Hong Kong. Various socio-demographic and clinical characteristics, physical and psychological variables were measured and considered as potential predictors. The sleep pattern and quality were assessed by subjective and objective means with validated study instruments and actigraphy. Descriptive statistics were used to summarize the sleep pattern and quality, while multivariate analysis was conducted to identify the independent predictors of poor sleep in patients with heart failure.
Results: In general, participants reported poor sleep pattern and quality with subjective and objective measurements. The mean Pittsburgh Sleep Quality Index score (PSQI) score as 10.5 (SD = 4.02) and up to two-third (68%) of the participants had the PSQI score >5, defined as poor sleepers. The actigraphy results indicated that the sleep efficiency was 72% (SD = 10.03). Symptom burden and dysfunctional sleep-related cognition were the most significant predictors of poor sleep. Older patients and those with more comorbidities also negatively influence their sleep pattern and quality. The final model accounted for 46.8% of the variance in poor sleep quality.
Conclusion: Sleep disturbance is prevalent among heart failure patients. The most prominent predictors are symptom burden and dysfunctional sleep-related cognition, which are modifiable. Although age and the comorbidities are non-modifiable in nature, the findings inform the high-risk individuals for sleep promoting interventions.
Audience take away:
• The audience will understand the sleep patterns and quality in heart failure patients.
• The audience will understand the predictors of sleep disturbance in heart failure patients, which can guide their clinical practice.
• In terms of research, this study will inform the audience on the design of future sleep promoting interventions.