Sleep quality and depression in hospitalized congestive heart failure patients

To assess the sleep pattern and depression in patients hospitalised with congestive heart failure, and to study the correlation of poor-quality sleep and depression.

The cross-sectional, descriptive, co-relational study was conducted from October 2011 to March 2012 and comprised New York Heart Association Class III or IV congestive heart failure patients aged >18 years, admitted at teaching hospitals of Rawalpindi, Pakistan. A standardised questionnaire designed in collaboration with cardiologists and psychiatrists of Rawalpindi Medical College and allied teaching hospitals was administered to the patients while they were hospitalised. Pittsburgh Sleep Quality Index and Beck Depression Inventory questionnaire were also used. Statistical analysis was done using SPSS 20.

Of the 40 patients recruited, 26(65%) were males and 14(35%) were females. The overall mean age was 60±13 years. The mean Pittsburgh Sleep Quality Index score was 15.6±3, with 37(92.5%) patients having poor sleep quality. The mean depression score was 27.65±7.5, with all 40(100%) patients affected. Among them, 14(35.7%) patients had severe clinical depression. Class IV congestive heart failure patients suffered from greater daytime dysfunction (p<0.008) and poor sleep efficiency (p<0.009) compared to Class III. No association of poor sleep quality and depression was found with previous history of smoking, diabetes and hypertension. The study revealed a significant relationship between sleep quality and depression (p<0.005).

Hospitalised congestive heart failure patients suffered from poor sleep and depressive symptoms with overall female predominance. The two symptoms were highly co-related and were more severe in Class IV patients than in Class III. A regular screening of such patients is thus essential for prognosis.