Descriptors of Insomnia among Patients with Heart Failure

Explore the characteristics of insomnia in persons with heart failure and identify the predictive factors of insomnia in patients with heart failure.

A predictive correlational research design was used. Three hundred forty heart failure patients followed-up at heart clinics, outpatient departments of 10 tertiary hospitals from all regions in Thailand, were selected by multi-stage random sampling. Data were collected between July 2009 and January 2010. Research instrument included demographic questionnaire, state-trait anxiety inventory questionnaire, Center for Epidemiologic Studies Depression Scale, dyspnea questionnaire, Berlin Questionnaire, hygiene awareness and practice scale, and dysfunctional beliefs and attitudes about sleep and insomnia severity index. Data were analyzed by using descriptive statistic, Chi-square test, and logistic regression.

Thirty-two percent of heart failure patients had insomnia. Eighty-one patients had moderate insomnia (23.8%), and 28 patients had severe insomnia (8.2%). Most heart failure patients had insomnia of mixed types (73.40%), including difficulty falling asleep, difficulty staying asleep, and waking up too early. Correlated factors of insomnia included the predisposing factors, anxiety and depression, the precipitating factors, marital status, dyspnea, sleep disorder breathing, and the perpetuating factors, sleep hygiene and dysfunctional beliefs and attitudes about sleep. After using logistic regression analysis, the predictive factors of insomnia were anxiety, depression, marital status (separated, divorced, and widowed), dyspnea, and dysfunctional beliefs and attitudes about sleep with a 95% confidence level (α = 0.05). However, age, gender,sleep disorder breathing, and sleep hygiene were not significant predictors of insomnia.

Insomnia is a significant problem in heart failures patients. Therefore, healthcare providers need to pay attention to this sensitive outcome. Several factors should be considered for further management.