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Gao X, Qiao Y, Chen Q, Wang C, Zhang P. Effects of different types of exercise on sleep quality based on Pittsburgh Sleep Quality Index in middle-aged and older adults: a network meta-analysis. J Clin Sleep Med 2024; 20:1193-1204. [PMID: 38450497 PMCID: PMC11217626 DOI: 10.5664/jcsm.11106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/27/2024] [Accepted: 02/27/2024] [Indexed: 03/08/2024]
Abstract
STUDY OBJECTIVES A 2021 survey by the World Health Organization showed that 27% of the global population experiences sleep problems and that middle-aged and older adults are more likely to have sleep disorders. Sleep deprivation increases cardiovascular disease risk. This study aimed to assess the effects of aerobic exercise, resistance exercise, combined training, and yoga on the quality of sleep in middle-aged and older adults through their effects on the Pittsburgh Sleep Quality Index (PSQI) and its components. Direct and indirect comparisons were used to determine which exercise modality most effectively improves sleep quality in middle-aged and older adults. METHODS This study conducted a systematic review and frequency network meta-analysis of all randomized controlled trials comparing the effects of aerobic exercise, resistance exercise, combined training, and yoga with a control group on sleep quality in middle-aged and older adults. RESULTS We included 28 studies involving 3,460 participants. According to the surface under the cumulative ranking (SUCRA) curve results, aerobic exercise was the most effective in improving total PSQI score (SUCRA = 93.2%), sleep latency (SUCRA = 96.8%), and sleep medication use (SUCRA = 77.1%). In addition, yoga was the most effective in improving sleep disorders (SUCRA = 90.4%), sleep efficiency (SUCRA = 95.9%), sleep duration (SUCRA = 93.8%), and daytime dysfunction (SUCRA = 98.3%). CONCLUSIONS Aerobic exercise is the most effective exercise modality for improving PSQI total score in middle-aged and older adults. SYSTEMATIC REVIEW REGISTRATION Registry: PROSPERO; Identifier: CRD42023454237. CITATION Gao X, Qiao Y, Chen Q, Wang C, Zhang P. Effects of different types of exercise on sleep quality based on Pittsburgh Sleep Quality Index in middle-aged and older adults: a network meta-analysis. J Clin Sleep Med. 2024;20(7):1193-1204.
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Affiliation(s)
- Xin Gao
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Yunheng Qiao
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Qin Chen
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Chen Wang
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Peizhen Zhang
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
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Thondala B, Pawar H, Chauhan G, Panjwani U. The effect of non-pharmacological interventions on sleep quality in people with sleep disturbances: A systematic review and a meta-analysis. Chronobiol Int 2023; 40:1333-1353. [PMID: 37853577 DOI: 10.1080/07420528.2023.2262567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 09/18/2023] [Indexed: 10/20/2023]
Abstract
Sleep is the elixir of life. Both healthy populations and patients with chronic diseases experience sleep disturbances in their lifetime. Pharmacological agents to induce sleep in individuals with sleep disturbances pose side effects like tolerance and dependence, warranting the development of alternative non-pharmacological interventions with less or no adverse effects. However, deciphering comprehensive evidence on the translational potential of these alternative therapies remains difficult. In the current paper, we systematically reviewed the recent literature on the effect of non-pharmacological interventions (NPIs) on improving sleep quality in both healthy and diseased populations experiencing sleep disturbances. We searched PubMed, Science Direct, Cochrane Controlled Trials, and Web of Science databases from inception to June 2022 for randomized controlled trials and cohort studies evaluating the sleep quality of individuals. We performed a meta-analysis using the random effects model with Pittsburgh Sleep Quality Index (PSQI) as an outcome measure to evaluate the effect of five distinct NPIs on sleep quality in normal and people with different medical conditions. Subgroup analyses and sensitivity analyses were done for heterogeneity analysis and to check the consistency of results, respectively. In 16 trials reporting on 1885 subjects, that all NPIs like Resistance Training (SMD -0.29, 95% CI -0.64 to 0.05; p = 0.09); Yoga (SMD -0.48, 95% CI -0.72 to -0.25; p < 0.0001); Cognitive Behavioral Therapy (SMD -1.69, 95% CI -2.70 to -0.68; p = 0.001); Music (SMD -1.42, 95% CI -1.99 to -0.85; p < 0.00001); Light (SMD -0.43, 95% CI -0.77 to -0.09; p = 0.01) have substantially decreased the global PSQI scores. The findings of the randomized studies and a cohort study included in qualitative synthesis demonstrated that the global PSQI scores improved significantly as compared to the placebo groups. Despite the limitations of clinical heterogeneity in subjects, our results demonstrate a positive impact of the studied NPIs on sleep quality in individuals experiencing sleep disturbances. However, comprehensive double-blinded controlled trials are indispensable in the future, emphasizing the objective sleep quality and inter-individual differences in response to the intervention.
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Affiliation(s)
- Bhanuteja Thondala
- Department of Soldier Performance, Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization, Delhi, India
| | - Harsh Pawar
- Department of Soldier Performance, Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization, Delhi, India
| | - Garima Chauhan
- Department of Soldier Performance, Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization, Delhi, India
| | - Usha Panjwani
- Department of Soldier Performance, Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization, Delhi, India
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Therapeutic Efficacy of Shexiang Baoxin Pill Combined with Exercise in Patients with Heart Failure with Preserved Ejection Fraction: A Single-Center, Double-Blind, Randomized Controlled Trial. Chin J Integr Med 2023; 29:99-107. [PMID: 36484921 PMCID: PMC9734389 DOI: 10.1007/s11655-022-3627-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To evaluate the therapeutic efficacy of Shexiang Baoxin Pill combined with exercise in heart failure patients with preserved ejection fraction (HFpEF). METHODS Sixty patients with HFpEF were randomly divided into group A (n=20), receiving Shexiang Baoxin Pill combined with home-based exercise training based on conventional drugs for 12 weeks; group B (n=20), receiving conventional drugs combined with home-based exercise training for 12 weeks; and group C (n=20), receiving conventional drug treatment only. Peak oxygen uptake (peakVO2), anaerobic threshold (AT), 6-min walking test (6MWT), Pittsburgh Sleep Quality Index (PSQI), and SF-36 questionnaire (SF-36) results before and after treatment were compared among groups. RESULTS After the 12-week intervention, patients in group C showed significant declines in peakVO2, AT, 6MWT, PSQI, and SF-36 compared with pre-treatment (P<0.01), while groups A and B both showed significant improvements in peakVO2, AT, 6MWT, PSQI, and SF-36 results compared with pre-treatment (P<0.01). Compared with group C, patients in groups A and B showed significant improvements in peakVO2, AT, 6MWT, PSQI, and SF-36 (P<0.01). In addition, patients in group A showed more significant improvements in physical function, role-physical, vitality, and mental health scores on the SF-36 questionnaire, and PSQI scores than those in group B (P<0.01). CONCLUSIONS Exercise training improved exercise tolerance, sleep quality and quality of life (QoL) in patients with HFpEF. Notably, Shexiang Baoxin Pill played an active role in sleep quality and QoL of patients with HFpEF. (The trial was registered in the Chinese Clinical Trial Registry (No. ChiCTR2100054322)).
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Lodi Rizzini F, Gómez-González AM, Conejero-Cisneros R, Romero-Blanco MJ, Maldonado-Barrionuevo A, Salinas-Sánchez P, Jiménez-Navarro M. Effects of Cardiac Rehabilitation on Sleep Quality in Heart Disease Patients with and without Heart Failure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16675. [PMID: 36554555 PMCID: PMC9779564 DOI: 10.3390/ijerph192416675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/03/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
Insomnia is a modifiable cardiovascular risk factor. Previous studies suggested that attending a cardiac rehabilitation program may improve sleep quality in cardiac patients and pointed out the association between heart failure and poor sleep quality. The primary aim of this study was to evaluate sleep quality in patients attending a Multidisciplinary Cardiac Rehabilitation Program (MRCP), and to compare sleep quality between patients with and without heart failure. A prospective observational study was carried out on a consecutive sample of 240 patients attending an 8-week MRCP; 50 patients (20.8%) were included due to heart failure (NYHA stages I-III) and the rest of them after having undergone any revascularization procedure or valvular surgery. Before and after the completion of the MRCP, the quality of sleep was assessed by the Pittsburgh Sleep Quality Index (PSQI) score. Post-intervention global PSQI scores were statistically significantly lower than those of pre-intervention (p = 0.008), but only 60 patients (25%) registered a clinically significant improvement. When comparing patients with heart failure with those without, no differences in sleep quality were found. This suggests that only a small percentage of patients can achieve clinically significant improvements in sleep quality attending conventional MCRP. Suggestions for future research are given.
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Affiliation(s)
- Fabio Lodi Rizzini
- PhD Program in Biomedicine, Translational Research and New Health Technologies, Faculty of Medicine, University of Málaga, 29010 Malaga, Spain
| | | | | | | | | | - Pablo Salinas-Sánchez
- Department of Human Anatomy, Legal Medicine and History of Science, Faculty of Medicine, University of Málaga, 29010 Malaga, Spain
| | - Manuel Jiménez-Navarro
- Cardiology Department, Virgen de la Victoria University Hospital, IBIMA, CIBERCV, UMA, 29010 Malaga, Spain
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He D, Pan M. Serial multiple mediators in the relationship between symptom burden and sleep quality among patients with heart failure. Jpn J Nurs Sci 2022; 19:e12489. [PMID: 35388623 DOI: 10.1111/jjns.12489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/08/2022] [Accepted: 03/11/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Sleep disturbance is common in patients with heart failure. The aims of this study were to assess the prevalence of sleep disturbance in patients with heart failure, and to examine the serial multiple mediation effects of psychological distress and sleep hygiene practices on the relationship between symptom burden and sleep quality. METHODS We recruited eligible heart failure patients in a large, university-affiliated hospital in Shandong Province, China, from November 2018 to June 2019. The Pittsburgh Sleep Quality Index, Heart Failure Somatic Perception Scale, Hospital Anxiety and Depression Scale, and Sleep Hygiene Practice Scale were used to assess patients' sleep quality, symptom burden, psychological distress, and sleep hygiene practices. The mediation effects were analyzed using the PROCESS tool in SPSS. RESULTS Two hundred and thirty seven heart failure patients were included in the final analyses. Among these patients, 189 patients (67.1%) had a sleep disturbance (Pittsburgh Sleep Quality Index score of >5). Higher symptom burden, higher level of psychological distress, and poorer sleep hygiene practices were associated with patients' poorer sleep quality. The psychological distress and sleep hygiene practices had mediation effects on the relationship between symptom burden and sleep quality in patients with heart failure. CONCLUSIONS Patients' symptom burden could affect their sleep quality through psychological distress and sleep hygiene practices besides a direct effect. Thus, psychological distress and sleep hygiene practices should be fully considered in the development of interventions to improve patients' sleep quality, apart from alleviating patients' symptom burden.
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Affiliation(s)
- Dengxin He
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, Hubei Province, China
| | - Minghao Pan
- School of Medicine, Xinyang Normal University, Xinyang, Henan Province, China
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Vizeshfar F, Ghelbash Z. Effect of a self-care training program using smartphones on general health, nutrition status, and sleep quality in the elderly. Psychogeriatrics 2021; 21:910-919. [PMID: 34558152 DOI: 10.1111/psyg.12766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 08/16/2021] [Accepted: 09/07/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Self-care training programs can be an important means for educating the elderly in behaviours that promote health and the quality of life. Since sleep disorders, and problems related to eating patterns and general health, become more apparent with age, we aimed to investigate the effect of a self-care training program using smartphones on general health, nutritional status, and sleep quality of the elderly. METHODS In this randomized quality improvement trial with a pretest/post-test design, 54 healthy and independent elderly were enrolled and randomly allocated to intervention and control groups. The interventions included 21 sessions of self-care training that were presented virtually using smartphones. RESULTS Significant differences before and after the intervention were observed for the intervention group with respect to measures of general health, nutrition, and sleep quality. CONCLUSION Training in health-promoting self-care behaviours, delivered by smartphone, should be considered as a major strategy for maintaining and promoting health among the elderly.
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Affiliation(s)
- Fatemeh Vizeshfar
- Department of Nursing, School of Nursing and Midwifery, Community Based Psychiatric Care Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zakiye Ghelbash
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Le Grande MR, Jackson AC, Beauchamp A, Kerr D, Driscoll A. Diagnostic accuracy and suitability of instruments that screen for obstructive sleep apnoea, insomnia and sleep quality in cardiac patients: a meta-analysis. Sleep Med 2021; 86:135-160. [PMID: 33674192 DOI: 10.1016/j.sleep.2021.02.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 01/29/2021] [Accepted: 02/08/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND A number of clinical guidelines recommend that all cardiac rehabilitation patients should be screened for potential sleep disorders with a validated screening instrument. There is currently no consensus on what specific tools should be used. OBJECTIVE To identify tools that are practical to use in the clinical environment and have high diagnostic accuracy. METHODS We systematically searched online databases to identify patient reported outcome instruments that have been used in published research studies to assess the likelihood of obstructive sleep apnoea (OSA) in cardiac patients. In studies that provided diagnostic data, these data were extracted and verified via an evidence-based diagnostic calculator. Where sufficient numbers of studies were available, a meta-analysis was conducted to determine pooled estimates of specificity, sensitivity and diagnostic odds ratios. Selected papers were qualitatively assessed using the Standards for Reporting Diagnostic accuracy studies (STARD). RESULTS Of the 21 instruments identified, six detected likelihood of OSA, two assessed daytime sleepiness, five assessed insomnia and eight examined sleep quality. A meta-analysis of 14 studies that assessed diagnostic accuracy of moderate OSA, revealed moderate sensitivity for the Berlin Questionnaire, Sens = 0.49 (95% CI 0.45-0.52) and good sensitivity for the Stop-BANG, Sens = 0.93 (95% CI 0.87-0.96) but poor specificity at standard cut-off criteria. CONCLUSION There are promising practical tools available to screen patients with OSA and other sleep disorders in cardiac rehabilitation settings, but specificity could be improved. Additional assessment of sleep quality may enhance prognostic ability with both OSA and insomnia screening.
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Affiliation(s)
- Michael R Le Grande
- Australian Centre for Heart Health, 75 Chetwynd Street, North Melbourne, VIC, 3051, Australia; Faculty of Health, Deakin University, Burwood, VIC, 3216, Australia; Melbourne Centre for Behaviour Change, School of Psychological Sciences, The University of Melbourne, Parkville, VIC, 3052, Australia.
| | - Alun C Jackson
- Australian Centre for Heart Health, 75 Chetwynd Street, North Melbourne, VIC, 3051, Australia; Faculty of Health, Deakin University, Burwood, VIC, 3216, Australia; Centre on Behavioural Health, Hong Kong University, Pakfulam, Hong Kong
| | - Alison Beauchamp
- Australian Centre for Heart Health, 75 Chetwynd Street, North Melbourne, VIC, 3051, Australia; Department of Medicine - Western Health, The University of Melbourne, VIC, 3052, Australia; Australian Institute for Musculoskeletal Science (AIMSS), St. Albans, VIC, 3021, Australia; School of Rural Health, Monash University, Newborough, VIC, 3825, Australia
| | - Debra Kerr
- Faculty of Health, Deakin University, Burwood, VIC, 3216, Australia
| | - Andrea Driscoll
- Faculty of Health, Deakin University, Burwood, VIC, 3216, Australia; Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Deakin University, Geelong, VIC, 3220, Australia
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Review of Trials on Exercise-Based Rehabilitation Interventions Following Acute Decompensated Heart Failure: OBSERVATIONS FROM THE WHO INTERNATIONAL CLINICAL TRIALS REGISTRY PLATFORM. J Cardiopulm Rehabil Prev 2021; 41:214-223. [PMID: 34158455 DOI: 10.1097/hcr.0000000000000583] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Cardiac rehabilitation is an important intervention for patients with heart failure. However, its clinical application in acute decompensated heart failure (ADHF) remains underutilized with limited research available. An assessment of current research in this area will help guide future investigations. The aim of this review is to summarize the current research focusing on rehabilitation interventions following recovery from ADHF. REVIEW METHODS A systematic search was carried out on all trials registered in the clinical trial registry database of the World Health Organization-International Clinical Trial Registry Platform (WHO-ICTRP). Studies focusing on ADHF and utilizing any exercise and rehabilitation-based intervention were included. RESULTS A majority of 11 trial protocols, including 3827 participants with low ejection fraction (<40%), were identified from the WHO-ICTRP database. Majority of the protocols (64%) focused on exercise-based interventions with approximately one-quarter (29%) focusing on neuromuscular electrical stimulation and one on noninvasive ventilation during exercise. Irrespective of the mode of exercise, all protocols employed low-moderate intensity training with outcomes focusing on physical function and quality of life. CONCLUSION Studies on rehabilitative interventions for ADHF are still in their early stages. More research is needed using innovative methodologies and testing for feasibility and fidelity.
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Long-term intradialytic hybrid exercise training on fatigue symptoms in patients receiving hemodialysis therapy. Int Urol Nephrol 2021; 53:771-784. [PMID: 33387217 DOI: 10.1007/s11255-020-02711-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/04/2020] [Indexed: 01/12/2023]
Abstract
PURPOSE Hemodialysis (HD) patients suffer from generalized weakness, exercise intolerance and muscle atrophy, all leading to generalized fatigue and lack of energy. HD patients spend at least 50% of their time in a functionally "switch off" mode with their fatigue sensations reaching a peak in the immediate hours after the dialysis session. The purpose of the current study was to assess the effectiveness of a nine-month hybrid intradialytic exercise program on fatigue symptoms occurring during and after hemodialysis session. METHODS Twenty stable hemodialysis patients were included in the study (59 ± 13.7 years; 16 males). All patients completed a 9-month supervised exercise training program composed of both aerobic cycling and resistance training during HD. Aspects related to physical and generalized fatigue were assessed via validated questionnaires, while physical performance was assessed by a battery of tests, before and after the intervention period. RESULTS Exercise capacity and physical performance were increased by an average of 65 and 40%, respectively. Patients reported feeling better during post-dialysis hours in question 1 (p = 0.000), question 3 (p = 0.009) and question 4 (p = 0.003) after the 9-month intervention. In addition, exercise training improved scores in cognitive function (p = 0.037), vitality (p = 0.05), depression (p = 0.000) and fatigue (p = 0.039). CONCLUSION The present study showed that a 9-month hybrid (aerobic + resistance) exercise training program improved symptoms of post-dialysis fatigue and overall general perception of fatigue. Hybrid exercise training is a safe and effective non-pharmacological approach to ameliorate fatigue symptoms in HD patients. TRIAL REGISTRATION NUMBER Trial registration number The study is registered at ClinicalTrials.gov (NCT01721551, 2012) as a clinical trial.
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Sato Y, Yoshihisa A, Hotsuki Y, Watanabe K, Kimishima Y, Kiko T, Kanno Y, Yokokawa T, Abe S, Misaka T, Sato T, Oikawa M, Kobayashi A, Yamaki T, Kunii H, Nakazato K, Ishida T, Takeishi Y. Associations of Benzodiazepine With Adverse Prognosis in Heart Failure Patients With Insomnia. J Am Heart Assoc 2020; 9:e013982. [PMID: 32200713 PMCID: PMC7428626 DOI: 10.1161/jaha.119.013982] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background The prognostic impact of benzodiazepines has been unclear in patients with heart failure (HF). Methods and Results This was a historical observational cohort study. A total of 826 patients who had been hospitalized for HF and were being treated for insomnia with either benzodiazepines or Z‐drugs (zolpidem, zopiclone, or eszopiclone), were enrolled and divided on the basis of their hypnotics: benzodiazepine group (n=488 [59.1%]) and Z group (n=338 [40.9%]). We compared the patient characteristics and postdischarge prognosis between the groups. The primary end points were rehospitalization for HF and cardiac death. The benzodiazepine group was older (age, 72.0 versus 69.0 years; P=0.010), had a higher prevalence of depression (17.4% versus 8.9%; P<0.001), and showed a higher use of loop diuretics (77.9% versus 67.8%; P=0.001). In the laboratory data, the benzodiazepine group demonstrated lower levels of hemoglobin (12.3 versus 13.0 g/dL; P=0.001), sodium (139.0 versus 140.0 mEq/L; P=0.018), and albumin (3.7 versus 3.9 g/dL; P=0.003). Kaplan‐Meier analysis showed that both end points were higher in the benzodiazepine group (rehospitalization for HF, log‐rank P=0.001; cardiac death, log‐rank P=0.043). Multiple Cox proportional hazard analysis revealed that the use of benzodiazepines was an independent predictor of rehospitalization for HF (hazard ratio, 1.530; 95% CI, 1.025–2.284; P=0.038). Furthermore, rehospitalization for HF was higher in the benzodiazepine group after propensity score matching (log‐rank P=0.036). Conclusions Benzodiazepine is associated with higher risk of rehospitalization for HF compared with Z‐drugs in patients with HF.
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Affiliation(s)
- Yu Sato
- Department of Cardiovascular Medicine Fukushima Medical University Fukushima Japan
| | - Akiomi Yoshihisa
- Department of Cardiovascular Medicine Fukushima Medical University Fukushima Japan.,Department of Advanced Cardiac Therapeutics Fukushima Medical University Fukushima Japan
| | - Yu Hotsuki
- Department of Cardiovascular Medicine Fukushima Medical University Fukushima Japan
| | - Koichiro Watanabe
- Department of Cardiovascular Medicine Fukushima Medical University Fukushima Japan
| | - Yusuke Kimishima
- Department of Cardiovascular Medicine Fukushima Medical University Fukushima Japan
| | - Takatoyo Kiko
- Department of Cardiovascular Medicine Fukushima Medical University Fukushima Japan
| | - Yuki Kanno
- Department of Cardiovascular Medicine Fukushima Medical University Fukushima Japan
| | - Tetsuro Yokokawa
- Department of Cardiovascular Medicine Fukushima Medical University Fukushima Japan
| | - Satoshi Abe
- Department of Cardiovascular Medicine Fukushima Medical University Fukushima Japan
| | - Tomofumi Misaka
- Department of Cardiovascular Medicine Fukushima Medical University Fukushima Japan.,Department of Advanced Cardiac Therapeutics Fukushima Medical University Fukushima Japan
| | - Takamasa Sato
- Department of Cardiovascular Medicine Fukushima Medical University Fukushima Japan
| | - Masayoshi Oikawa
- Department of Cardiovascular Medicine Fukushima Medical University Fukushima Japan
| | - Atsushi Kobayashi
- Department of Cardiovascular Medicine Fukushima Medical University Fukushima Japan
| | - Takayoshi Yamaki
- Department of Cardiovascular Medicine Fukushima Medical University Fukushima Japan
| | - Hiroyuki Kunii
- Department of Cardiovascular Medicine Fukushima Medical University Fukushima Japan
| | - Kazuhiko Nakazato
- Department of Cardiovascular Medicine Fukushima Medical University Fukushima Japan
| | - Takafumi Ishida
- Department of Cardiovascular Medicine Fukushima Medical University Fukushima Japan
| | - Yasuchika Takeishi
- Department of Cardiovascular Medicine Fukushima Medical University Fukushima Japan
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Abstract
The occurrence of depression, anxiety, and insomnia is strikingly high in patients with heart failure and is linked to increased morbidity and mortality. However, symptoms are frequently unrecognized and the integration of mental health into cardiology care plans is not routine. This article describes the prevalence, identification, and treatment of common comorbid psychological disorders.
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Affiliation(s)
- Katherine E Di Palo
- Office of the Medical Director, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467, USA.
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Tumusiime DK, Stewart A, Venter FWD, Musenge E. The effects of a physiotherapist-led exercise intervention on peripheral neuropathy among people living with HIV on antiretroviral therapy in Kigali, Rwanda. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2019; 75:1328. [PMID: 31535052 PMCID: PMC6739563 DOI: 10.4102/sajp.v75i1.1328] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 05/24/2019] [Indexed: 11/08/2022] Open
Abstract
Background HIV-associated peripheral neuropathy (PN) is common in people living with HIV. Its management is mostly symptomatic utilising pharmacological approaches. Objectives This study determined the effects of an exercise intervention on PN among Rwandan people living with HIV receiving antiretroviral therapy (ART). Methods A 12-week single-blinded randomised controlled trial using the Brief Peripheral Neuropathy Screen (BPNS) as the assessment tool tested the effects of an exercise intervention on PN, followed by a 12-week non-intervention period. A total of 120 people with HIV- associated PN on ART were randomised to an exercise or no exercise group. Both groups continued receiving routine care. A bivariate analysis using Pearson’s chi-square test for significant differences in PN symptoms and signs, between groups, at baseline, after the 12 weeks intervention and 12 weeks post-intervention using generalised linear regression models to determine predictors of treatment outcomes was undertaken, utilising an intention-to-treat analysis (alpha p ≤ 0.05). Results At 12 weeks, the intervention group compared to the control: neuropathic pain 70% versus 94% (p < 0.005), PN symptoms severity – mild and/or none in 85% versus 60% (p < 0.001) and radiation of PN symptoms reduced, 80% versus 37% (p < 0.001). There were no differences in PN signs at 12 weeks intervention and at 12 weeks post-intervention. Having changed the antiretroviral (ARV) and having developed PN symptoms after the start on ARVs predicted treatment improvement, while demographic factors did not predict any treatment outcome. Conclusion A physiotherapist-led exercise intervention improved PN symptoms, but with non-significant improvement in PN signs. Factors related to early diagnosis and treatment of PN were facilitators for the improvement of PN symptoms. Clinical implications Physiotherapist-led exercises should be integrated into the routine management of people living with HIV on ART with PN symptoms.
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Affiliation(s)
- David K Tumusiime
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Aimée Stewart
- Department of Physiotherapy, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Francois W D Venter
- Witwatersrand Reproductive Health and HIV Institute (WRHI), Johannesburg, South Africa.,Department of Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Eustasius Musenge
- Division of Biostatistics and Epidemiology, School of Public Health, University of Witwatersrand, Johannesburg, South Africa
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Harris KM, Schiele SE, Emery CF. Pilot randomized trial of brief behavioral treatment for insomnia in patients with heart failure. Heart Lung 2019; 48:373-380. [DOI: 10.1016/j.hrtlng.2019.06.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 06/07/2019] [Accepted: 06/13/2019] [Indexed: 01/07/2023]
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Gullvåg M, Gjeilo KH, Fålun N, Norekvål TM, Mo R, Broström A. Sleepless nights and sleepy days: a qualitative study exploring the experiences of patients with chronic heart failure and newly verified sleep-disordered breathing. Scand J Caring Sci 2019; 33:750-759. [PMID: 30866061 DOI: 10.1111/scs.12672] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 01/27/2019] [Indexed: 01/18/2023]
Abstract
BACKGROUND Sleep-disordered breathing, including obstructive sleep apnoea and central sleep apnoea, is a common disorder among patients with chronic heart failure. Obstructive sleep apnoea is often treated with continuous positive airway pressure, but central sleep apnoea lacks a clear treatment option. Knowledge of how sleep-disordered breathing is experienced (e.g. difficulties and care needs) and handled (e.g. self-care actions) by the patients is limited, but needed, to provide patient-centred care. AIM To explore how newly verified sleep-disordered breathing is experienced by patients with chronic heart failure. METHODS Data were collected through semi-structured interviews and analysed with qualitative content analysis. Seventeen participants (14 men, three women), mean age 60 years (range 41-80) diagnosed with chronic heart failure and objectively verified sleep-disordered breathing (nine obstructive, seven central and one mixed) were strategically selected from heart failure outpatient clinics at two Norwegian university hospitals. RESULTS Patients with chronic heart failure and newly verified sleep-disordered breathing (SDB) described experiences of poor sleep that had consequences for their daily life and their partners. Different self-care strategies were revealed, but they were based on 'common sense' and were not evidence-based. The awareness of having SDB was varied; for some, it gave an explanation to their trouble while others were surprised by the finding. CONCLUSION Patients with chronic heart failure and sleep-disordered breathing experienced reduced sleep quality, influencing their daily life. Possible underlying causes of disrupted sleep, such as sleep-disordered breathing, should be identified to establish proper patient-centred treatment strategies. There is a need for new strategies to approach patients with chronic heart failure (i.e. those with central sleep apnoea) who are not subject to continuous positive airway pressure treatment for their sleep-disordered breathing.
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Affiliation(s)
- Marianne Gullvåg
- Department of Cardiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Kari Hanne Gjeilo
- Department of Cardiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Cardiothoracic Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Nina Fålun
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.,Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Tone M Norekvål
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.,Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Rune Mo
- Department of Cardiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Anders Broström
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.,School of Health Sciences, Jönköping University, Jönköping, Sweden.,Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden
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16
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Long L, Mordi IR, Bridges C, Sagar VA, Davies EJ, Coats AJS, Dalal H, Rees K, Singh SJ, Taylor RS. Exercise-based cardiac rehabilitation for adults with heart failure. Cochrane Database Syst Rev 2019; 1:CD003331. [PMID: 30695817 PMCID: PMC6492482 DOI: 10.1002/14651858.cd003331.pub5] [Citation(s) in RCA: 186] [Impact Index Per Article: 37.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Chronic heart failure (HF) is a growing global health challenge. People with HF experience substantial burden that includes low exercise tolerance, poor health-related quality of life (HRQoL), increased risk of mortality and hospital admission, and high healthcare costs. The previous (2014) Cochrane systematic review reported that exercise-based cardiac rehabilitation (CR) compared to no exercise control shows improvement in HRQoL and hospital admission among people with HF, as well as possible reduction in mortality over the longer term, and that these reductions appear to be consistent across patient and programme characteristics. Limitations noted by the authors of this previous Cochrane Review include the following: (1) most trials were undertaken in patients with HF with reduced (< 45%) ejection fraction (HFrEF), and women, older people, and those with preserved (≥ 45%) ejection fraction HF (HFpEF) were under-represented; and (2) most trials were undertaken in the hospital/centre-based setting. OBJECTIVES To determine the effects of exercise-based cardiac rehabilitation on mortality, hospital admission, and health-related quality of life of people with heart failure. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and three other databases on 29 January 2018. We also checked the bibliographies of systematic reviews and two trial registers. SELECTION CRITERIA We included randomised controlled trials that compared exercise-based CR interventions with six months' or longer follow-up versus a no exercise control that could include usual medical care. The study population comprised adults (> 18 years) with evidence of HF - either HFrEF or HFpEF. DATA COLLECTION AND ANALYSIS Two review authors independently screened all identified references and rejected those that were clearly ineligible for inclusion in the review. We obtained full papers of potentially relevant trials. Two review authors independently extracted data from the included trials, assessed their risk of bias, and performed GRADE analyses. MAIN RESULTS We included 44 trials (5783 participants with HF) with a median of six months' follow-up. For this latest update, we identified 11 new trials (N = 1040), in addition to the previously identified 33 trials. Although the evidence base includes predominantly patients with HFrEF with New York Heart Association classes II and III receiving centre-based exercise-based CR programmes, a growing body of studies include patients with HFpEF and are undertaken in a home-based setting. All included studies included a no formal exercise training intervention comparator. However, a wide range of comparators were seen across studies that included active intervention (i.e. education, psychological intervention) or usual medical care alone. The overall risk of bias of included trials was low or unclear, and we downgraded results using the GRADE tool for all but one outcome.Cardiac rehabilitation may make little or no difference in all-cause mortality over the short term (≤ one year of follow-up) (27 trials, 28 comparisons (2596 participants): intervention 67/1302 (5.1%) vs control 75/1294 (5.8%); risk ratio (RR) 0.89, 95% confidence interval (CI) 0.66 to 1.21; low-quality GRADE evidence) but may improve all-cause mortality in the long term (> 12 months follow up) (6 trials/comparisons (2845 participants): intervention 244/1418 (17.2%) vs control 280/1427 (19.6%) events): RR 0.88, 95% CI 0.75 to 1.02; high-quality evidence). Researchers provided no data on deaths due to HF. CR probably reduces overall hospital admissions in the short term (up to one year of follow-up) (21 trials, 21 comparisons (2182 participants): (intervention 180/1093 (16.5%) vs control 258/1089 (23.7%); RR 0.70, 95% CI 0.60 to 0.83; moderate-quality evidence, number needed to treat: 14) and may reduce HF-specific hospitalisation (14 trials, 15 comparisons (1114 participants): (intervention 40/562 (7.1%) vs control 61/552 (11.1%) RR 0.59, 95% CI 0.42 to 0.84; low-quality evidence, number needed to treat: 25). After CR, a clinically important improvement in short-term disease-specific health-related quality of life may be evident (Minnesota Living With Heart Failure questionnaire - 17 trials, 18 comparisons (1995 participants): mean difference (MD) -7.11 points, 95% CI -10.49 to -3.73; low-quality evidence). Pooling across all studies, regardless of the HRQoL measure used, shows there may be clinically important improvement with exercise (26 trials, 29 comparisons (3833 participants); standardised mean difference (SMD) -0.60, 95% CI -0.82 to -0.39; I² = 87%; Chi² = 215.03; low-quality evidence). ExCR effects appeared to be consistent different models of ExCR delivery: centre vs. home-based, exercise dose, exercise only vs. comprehensive programmes, and aerobic training alone vs aerobic plus resistance programmes. AUTHORS' CONCLUSIONS This updated Cochrane Review provides additional randomised evidence (11 trials) to support the conclusions of the previous version (2014) of this Cochane Review. Compared to no exercise control, CR appears to have no impact on mortality in the short term (< 12 months' follow-up). Low- to moderate-quality evidence shows that CR probably reduces the risk of all-cause hospital admissions and may reduce HF-specific hospital admissions in the short term (up to 12 months). CR may confer a clinically important improvement in health-related quality of life, although we remain uncertain about this because the evidence is of low quality. Future ExCR trials need to continue to consider the recruitment of traditionally less represented HF patient groups including older, female, and HFpEF patients, and alternative CR delivery settings including home- and using technology-based programmes.
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Affiliation(s)
- Linda Long
- University of Exeter Medical SchoolInstitute of Health ResearchExeterUK
| | - Ify R Mordi
- University of DundeeMolecular and Clinical MedicineNinewells Hospital and Medical SchoolDundeeUK
| | - Charlene Bridges
- University College LondonInstitute of Health Informatics Research222 Euston RoadLondonUKNW1 2DA
| | - Viral A Sagar
- King's College HospitalDenmark HillBrixtonLondonUKSE5 9RS
| | - Edward J Davies
- Royal Devon & Exeter Healthcare Foundation TrustDepartment of CardiologyBarrack RoadExeterDevonUKEX2 5DW
| | - Andrew JS Coats
- University of East AngliaElizabeth Fry Building University of East AngliaNorwichNorfolkUKNR4 7TJ
| | - Hasnain Dalal
- University of Exeter Medical SchoolInstitute of Health ResearchExeterUK
- University of Exeter Medical School, Truro Campus, Knowledge Spa, Royal Cornwall Hospitals TrustDepartment of Primary CareTruroUKTR1 3HD
| | - Karen Rees
- University of WarwickDivision of Health Sciences, Warwick Medical SchoolCoventryUKCV4 7AL
| | - Sally J Singh
- Glenfield HospitalCardiac and Pulmonary RehabilitationUniversity Hospitals of LeicesterLeicesterUKLE3 9QP
| | - Rod S Taylor
- University of Exeter Medical SchoolInstitute of Health ResearchExeterUK
- University of GlasgowInstitute of Health & WellbeingGlasgowUK
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17
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Wang Z, Peng X, Li K, Wu CJJ. Effects of combined aerobic and resistance training in patients with heart failure: A meta-analysis of randomized, controlled trials. Nurs Health Sci 2019; 21:148-156. [DOI: 10.1111/nhs.12593] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 11/21/2018] [Accepted: 11/23/2018] [Indexed: 12/24/2022]
Affiliation(s)
- ZeQuan Wang
- School of Nursing; Jilin University; Changchun China
| | - Xin Peng
- School of Nursing; Jilin University; Changchun China
| | - Kun Li
- School of Nursing; Jilin University; Changchun China
| | - Chiung-Jung Jo Wu
- School of Nursing, Midwifery and Paramedicine; University of the Sunshine Coast; Sunshine Coast Queensland Australia
- Royal Brisbane and Women's Hospital; Brisbane Queensland Australia
- Mater Medical Research Institute, University of Queensland; Brisbane Queensland Australia
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18
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D'Aurea CVR, Poyares D, Passos GS, Santana MG, Youngstedt SD, Souza AA, Bicudo J, Tufik S, de Mello MT. Effects of resistance exercise training and stretching on chronic insomnia. ACTA ACUST UNITED AC 2018; 41:51-57. [PMID: 30328967 PMCID: PMC6781703 DOI: 10.1590/1516-4446-2018-0030] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 04/24/2018] [Indexed: 12/19/2022]
Abstract
Objective: The aim of this study was to assess the effects of resistance exercise and stretching on sleep, mood, and quality of life in chronic insomnia patients. Methods: Three 4-month treatments included: resistance exercise (n=10), stretching (n=10), and control (n=8). Sleep was evaluated with polysomnography, actigraphy, and questionnaires. Mood and quality of life were assessed with the Profile of Mood States (POMS) and the Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36), respectively. Results: There were no significant treatment differences between resistance exercise and stretching. However, compared with the control treatment, resistance exercise and stretching led to significantly greater improvements in Insomnia Severity Index scores (-10.5±2.3, -8.1±2.0 vs. 2.3±1.8, respectively), and actigraphic measures of sleep latency (-7.1±4.6, -5.2±1.9 vs. 2.2±2.1 min), wake after sleep onset (-9.3±2.8, -7.1±3.0 vs. 3.6±4.2 min), and sleep efficiency (4.4±1.8, 5.0±0.8 vs. -2.3±2%). Pittsburgh Sleep Quality Index (PSQI) global scores (-5.3±0.8, -3.9±1.5 vs. -0.1±0.8) and sleep duration (1.2±0.3, 1.6±0.6 vs. -0.1±0.2 h) also improved following both experimental treatments compared with control. PSQI-Sleep efficiency increased after resistance exercise compared with control (19.5±3.9 vs. 2.1±4.3%). No significant differences were observed in polysomnography or quality of life measures. Tension-anxiety was lower in the stretching group than the control group. Conclusion: Moderate-intensity resistance exercise and stretching led to similar improvements in objective and subjective sleep in patients with chronic insomnia. Clinical trial registration: NCT01571115
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Affiliation(s)
- Carolina V R D'Aurea
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Dalva Poyares
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | | | | | - Shawn D Youngstedt
- Phoenix VA Health Care System, College of Nursing and Health Innovation and College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Altay A Souza
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Juliana Bicudo
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Marco T de Mello
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.,Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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19
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Ghavami H, Safarzadeh F, Asl RGA. Effect of self-care interventions on sleep quality in post-coronary artery bypass grafting patients: A single-center, randomized-controlled study. TURK GOGUS KALP DAMAR CERRAHISI DERGISI 2018; 26:550-556. [PMID: 32082796 PMCID: PMC7018196 DOI: 10.5606/tgkdc.dergisi.2018.16789] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 07/25/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND This study aims to evaluate the effect of self-care interventions based on sleep hygiene practices, nutrition, and physical activity on sleep quality in post-coronary artery bypass grafting patients. METHODS This randomized-controlled study included a total of 146 patients (109 males, 37 females; mean age 55.31 years; range, 41 to 65 years) who underwent isolated coronary artery bypass grafting at Seyyed Al- Shohada Hospital of Urmia Medical Sciences University, between September 2017 and May 2018. The patients were divided into two groups as the self-care intervention group (n=73) and as the control group (n=73). The self-care intervention group received six educational courses on sleep hygiene, nutrition, and physical activity. Then they received individualized consulting weekly for three months. The control group was instructed to continue their normal life and routine care and received no education. The Demographic Information Form and the Pittsburgh Sleep Quality Index were used for data collection. RESULTS The mean Pittsburgh Sleep Quality Index scores in the self-care intervention group decreased to 7.1±2.3 after the intervention, while it increased to 9.5±2.1 in the control group. There was no significant difference between the two groups in terms of the mean global Pittsburgh Sleep Quality Index scores before the study (p=0.91); however, the scores were statistically significantly higher after the self-care intervention (p=0.001). CONCLUSION Patients undergoing coronary artery bypass grafting may benefit from self-care interventions based on sleep hygiene, nutrition, and physical activity to improve the quality of sleep.
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Affiliation(s)
- Haleh Ghavami
- Department of Medical Surgical Nursing, Urmia Medical Sciences University, Urmia, Iran
| | - Fahimeh Safarzadeh
- Department of Medical Surgical Nursing, Urmia Medical Sciences University, Urmia, Iran
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20
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Awotidebe TO, Adeyeye VO, Adedoyin RA, Ogunyemi SA, Oke KI, Ativie RN, Adeola GB, Akindele MO, Balogun MO. Assessment of functional capacity and sleep quality of patients with chronic heart failure. Hong Kong Physiother J 2016; 36:17-24. [PMID: 30931035 PMCID: PMC6385089 DOI: 10.1016/j.hkpj.2016.10.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 08/15/2017] [Accepted: 10/02/2016] [Indexed: 01/02/2023] Open
Abstract
Background: Adequate sleep improves physical and mental alertness. However, there is a dearth of empirical data on functional capacity (FC) and sleep quality (SpQ) in patients with chronic heart failure (CHF). Objective: This study investigated the relationship between FC and SpQ of patients with CHF and apparently healthy controls (HCs). Methods: This case-control study recruited 50 patients with CHF whose left ventricular ejection fraction (LVEF) was <40%, attending cardiac clinics of selected government hospitals in Osun State. Furthermore, 50 age- and sex-matched healthy individuals were recruited as controls. Socio-demographic characteristics and cardiovascular parameters were assessed. The FC (VO2 max) and SpQ were assessed using the 6-minute walk test (6-MWT) and Pittsburgh Sleep Quality Index (PSQI), respectively. Data were analysed using descriptive and inferential statistics. Alpha level was set at p < 0.05. Results: Patients had a significantly lower FC and poorer SpQ than HCs, 4.6 ± 0.5 versus 11.3 ± 1.6 mL/kg/min (t = −3.452; p = 0.001) and 8.74 ± 1.6 versus 3.8 ± 1.3 (t = −5.371; p = 0.001), respectively. HCs were about five times more likely to walk longer distance [odds ratio (OR), 4.8; confidence interval (CI), 2.0–11.1] and had a better heart rate (OR, 2.8; CI, 1.4–5.3) than patients. SpQ had a significant negative correlation with FC of patients (r = −0.362; p = 0.001) but a significant positive correlation with HCs (r = 0.481; p = 0.041). Furthermore, there were significant correlations between FC and body mass index in both groups (CHF: r = 0.247, p = 0.022; HCs: r = 0.321, p = 0.040). Conclusion: Patients with heart failure demonstrated lower functional capacity and poorer sleep quality.
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Affiliation(s)
- Taofeek O Awotidebe
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Victor O Adeyeye
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Rufus A Adedoyin
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Suraj A Ogunyemi
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.,Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Kayode I Oke
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Rita N Ativie
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Goodness B Adeola
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Mukadas O Akindele
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Michael O Balogun
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.,Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
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21
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Kanno Y, Yoshihisa A, Watanabe S, Takiguchi M, Yokokawa T, Sato A, Miura S, Shimizu T, Nakamura Y, Abe S, Sato T, Suzuki S, Oikawa M, Saitoh SI, Takeishi Y. Prognostic Significance of Insomnia in Heart Failure. Circ J 2016; 80:1571-7. [DOI: 10.1253/circj.cj-16-0205] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yuki Kanno
- Department of Cardiology and Hematology, Fukushima Medical University
| | - Akiomi Yoshihisa
- Department of Cardiology and Hematology, Fukushima Medical University
- Department of Advanced Cardiac Therapeutics, Fukushima Medical University
| | - Shunsuke Watanabe
- Department of Cardiology and Hematology, Fukushima Medical University
| | - Mai Takiguchi
- Department of Cardiology and Hematology, Fukushima Medical University
| | - Tetsuro Yokokawa
- Department of Cardiology and Hematology, Fukushima Medical University
| | - Akihiko Sato
- Department of Cardiology and Hematology, Fukushima Medical University
| | - Shunsuke Miura
- Department of Cardiology and Hematology, Fukushima Medical University
| | - Takeshi Shimizu
- Department of Cardiology and Hematology, Fukushima Medical University
| | - Yuichi Nakamura
- Department of Cardiology and Hematology, Fukushima Medical University
| | - Satoshi Abe
- Department of Cardiology and Hematology, Fukushima Medical University
| | - Takamasa Sato
- Department of Cardiology and Hematology, Fukushima Medical University
| | - Satoshi Suzuki
- Department of Cardiology and Hematology, Fukushima Medical University
- Department of Advanced Cardiac Therapeutics, Fukushima Medical University
| | - Masayoshi Oikawa
- Department of Cardiology and Hematology, Fukushima Medical University
| | - Shu-ichi Saitoh
- Department of Cardiology and Hematology, Fukushima Medical University
| | - Yasuchika Takeishi
- Department of Cardiology and Hematology, Fukushima Medical University
- Department of Advanced Cardiac Therapeutics, Fukushima Medical University
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22
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Andrechuk CRS, Ceolim MF. SLEEP QUALITY IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION. TEXTO & CONTEXTO ENFERMAGEM 2015. [DOI: 10.1590/0104-0707201500002970014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
ABSTRACT The aim of this study was to describe sleep quality and to identify associated factors in patients hospitalized with acute myocardial infarction. A descriptive and cross-sectional study was conducted with 113 patients (70.8% men, mean age 59.7 years). An instrument was used for sociodemographic and clinical characterization and the Pittsburgh Sleep Quality Index. Results showed that 71.7% of participants had poor sleep quality and over 64% slept six hours or less per night. The presence of diabetes mellitus, depression, and absence of physical activity contributed to increase the final score of the Pittsburgh Sleep Quality Index in about 2.5 points for each variable. The identification of sleep quality and proposals of interventions to improve sleep quality must be included in the actions of nurses in order to reduce harm to patients' health before and after the acute myocardial infarction episode.
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23
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Gardner B, Broström A, Nilsen P, Hrubos Ström H, Ulander M, Fridlund B, Skagerström J, Johansson P. From ‘does it work?’ to ‘what makes it work?’: The importance of making assumptions explicit when designing and evaluating behavioural interventions. Eur J Cardiovasc Nurs 2014; 13:292-4. [DOI: 10.1177/1474515114531688] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Benjamin Gardner
- Department of Epidemiology and Public Health, University College London, UK
| | - Anders Broström
- Department of Nursing Science, Jönköping University, Sweden
- Department of Clinical Neurophysiology, Linköping University Hospital, Sweden
| | - Per Nilsen
- Department of Health and Society, Linköping University, Sweden
| | | | - Martin Ulander
- Department of Clinical Neurophysiology, Linköping University Hospital, Sweden
| | - Bengt Fridlund
- Department of Nursing Science, Jönköping University, Sweden
| | | | - Peter Johansson
- Department of Cardiology, Linköping University Hospital, Sweden
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