Sleep Quality in the Advanced Heart Failure ICU
Elizabeth A Edmiston1,2, Heather K Hardin3, Mary A Dolansky1,2
1VA Northeast Ohio Health System, Cleveland, OH, USA.
Clinical Nursing Research
|March 6, 2023
Summary
Patients with advanced heart failure (HF) experience poor sleep quality, especially during hospitalization. While sleep quality improves post-discharge, interventions are needed to enhance hospital sleep and support self-management for better heart failure outcomes.
Area of Science:
- Cardiology
- Sleep Medicine
- Critical Care Medicine
Background:
- Advanced heart failure (HF) patients admitted to intensive care units (ICUs) often experience significant sleep disturbances.
- Poor sleep quality can negatively impact patient recovery and overall health outcomes in critically ill populations.
Purpose of the Study:
- To evaluate changes in sleep quality among patients with advanced heart failure during ICU admission, hospitalization, and post-discharge.
- To identify specific sleep parameters affected by hospitalization in this patient group.
Main Methods:
- A longitudinal study design was employed, assessing sleep quality in 22 patients with advanced heart failure.
- Sleep quality was measured at three time points: ICU admission, during hospitalization, and post-discharge.
- Statistical analyses compared within-subject changes in global sleep quality, subjective sleep quality, sleep duration, and habitual sleep efficiency over time.
Main Results:
- A high prevalence of poor sleep quality was observed: 96% at admission, 96% during hospitalization, and 86% post-discharge.
- Significant differences were detected in global sleep quality, subjective sleep quality, sleep duration, and habitual sleep efficiency across the assessed time points.
- Hospitalization was associated with a higher proportion of poor global sleep quality compared to previous reports.
Conclusions:
- Patients with advanced heart failure exhibit persistent poor sleep quality throughout their hospital stay, with some improvement after discharge.
- Interventions aimed at improving sleep within the hospital environment and providing home-based sleep self-management education are crucial for enhancing heart failure outcomes.
- Implementation science is recommended to effectively integrate evidence-based sleep interventions for this vulnerable patient population.
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