Cognitive behavioral therapy for insomnia has sustained effects on insomnia, fatigue, and function among people with chronic heart failure and insomnia: the HeartSleep Study

Sleep

article

Redeker, Nancy S¹  Yaggi, Henry Klar²  Jacoby, Daniel²  Hollenbeak, Christopher S³  Breazeale, Stephen¹  Conley, Samantha¹  Hwang, Youri¹  Iennaco, Joanne¹  Linsky, Sarah¹  Nwanaji-Enwerem, Uzoji¹  O’Connell, Meghan¹  Jeon, Sangchoon¹ 

[1] Yale School of Nursing;Pulmonary Critical Care and Sleep Medicine, Yale School of Medicine;Department of Health Policy and Administration, Pennsylvania State University, University Park

关键词: self-management;    heart failure;    insomnia;    cognitive behavioral therapy;    sleep;    fatigue;    function;    actigraphy;   

DOI  :  10.1093/sleep/zsab252

学科分类：生理学

来源: American Academy of Sleep Medicine

【 摘 要 】

Study Objectives Insomnia is common among adults with chronic heart failure (HF) and associated with daytime symptoms and decrements in function. The purpose of this randomized controlled trial (RCT) was to evaluate the sustained effects over one year of CBT-I (Healthy Sleep: HS) compared with HF self-management education (Healthy Hearts; attention control: HH) on insomnia severity, sleep characteristics, symptoms, and function among people with stable HF. The primary outcomes were insomnia severity, actigraph-recorded sleep efficiency, and fatigue.Methods7) in groups to HS or HH (4 sessions/8 weeks). We obtained wrist actigraphy and measured insomnia severity, self-reported sleep characteristics, symptoms (fatigue, excessive daytime sleepiness, anxiety, depression), and six-minute walk distance at baseline, within one month of treatment, and at 6 and 12 months. We used general linear mixed models (GLMM) and generalized estimating equations (GEE) to evaluate the effects.Results The sample included 175 participants (M age = 63 ± 12.9 years; 43% women; 18% Black; 68% New York Heart Association Class II or II; 33%; LVEF < 45%) randomized to HS (n = 91) or HH (n = 84). HS had sustained effects on insomnia severity, sleep quality, self-reported sleep latency and efficiency, fatigue, excessive daytime sleepiness, and six-minute walk distance at 12 months.Conclusions CBT-I produced sustained improvements in insomnia, fatigue, daytime sleepiness, and objectively measured physical function among adults with chronic HF, compared with a robust HF self-management program that included sleep hygiene education.Clinical Trial Information Insomnia Self-Management in Heart Failure; https://clinicaltrials.gov/ct2/show/NCT02660385; NCT02660385.

【 授权许可】

All Rights reserved