healthmedicinet

Poor sleep doubles hospitalisations in heart failure, according to new research in nearly 500 patients presented today at EuroHeartCare 2014.

EuroHeartCare is the official annual meeting of the Council on Cardiovascular Nursing and Allied Professions (CCNAP) of the European Society of Cardiology (ESC). This year’s meeting is organised jointly with the Norwegian Society of Cardiovascular Nurses. It takes place 4-5 April in Stavanger, Norway.

Dr Peter Johansson, first author of the study and a heart failure nurse at the University Hospital of Link-ping, Sweden, said: “Sleep is important for everyone and we all have to sleep to feel good. We know that sleep problems are common among patients with heart failure. But until now there was no data on whether poor sleep persists over time and how that relates to hospitalisations.”

He added: “Our study shows that some patients with heart failure have chronic sleep problems and this more than doubles their risk of unplanned hospitalisations. We need to ask all our heart failure patients whether they sleep well and if not, find out why.”

The current study included 499 patients hospitalised for heart failure who participated in the Co-ordinating study evaluating Outcomes of Advising and Counselling in Heart failure (COACH) study. During the initial hospitalisation, information was collected on physical functioning, mental health and sleep. Sleep problems were assessed using the question “Was your sleep restless?” from the Centre for Epidemiologic Studies Depression Scale (CES-D). After 12 months the researchers recorded the number and cause of unplanned hospitalisations during the follow up period and assessed sleep again.

The researchers found that 215 patients (43%) had sleep problems at discharge from the initial hospitalisation and nearly one-third (30%) had continued sleep problems at 12 months. Patients with continued sleep problems were two times more likely to be hospitalised during the follow up period than those without any sleep problems. Risk was double for all-cause hospitalisations and for cardiovascular hospitalisations. The results were adjusted for physical and mental health factors to ensure that the association was real.

Of the 284 patients without sleep problems at initial discharge, 14% developed a sleep problem during the follow up period. There was a trend for these patients to have more cardiovascular hospitalisations than patients without sleep problems but the finding was not significant.

Dr Johansson said: “Our finding that consistently poor sleep leads to twice as many hospitalisations in patients with heart failure underlines the impact that sleep can have on health. In Sweden we don’t generally ask our heart failure patients about sleep and this study shows that we should. If patients say their sleep is poor that may be a warning signal to investigate the reasons.”