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Poor sleep doubles admissions in heart failure patients

Heart failure admission cases double when a patient has had poor sleep, according to new research presented at a nursing conference.

Although sleep problems are common among people with heart conditions, until now there has been no data on how poor sleep persists, or how that relates to people being taken to hospital, said researchers.

Dr Peter Johansson, lead author of a study conducted by the University Hospital of Linkoping, Sweden, said: “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,” he said.

Nearly 500 patients took part in the study (see abstract attached, top-right), which was presented earlier this week at the EuroHeartCare2014 cardiology nursing conference in Stavanger, Norway.

After 12 months, the number and cause of unplanned hospital trips were recorded, with an assessment on sleep patterns.

“We need to ask all our heart failure patients whether they sleep well”

Peter Johansson

It was found that 215 patients (43%) had sleep problems following discharge, with just under a third having continued difficulties with sleep at the 12-month stage. Those who had continued sleep problems were more likely to be admitted to hospital in the follow-up period than those without.

For all-cause hospital admission and cardiovascular cases, the risk was double. Of the 284 patients without any sleep issues, 14% developed a sleep problem in the follow-up period.

There was a trend for such patients to have more cardiovascular hospital admissions than those without sleep problems, but not to any significant degree.

Dr Johansson said: “Patients may have poor sleep hygiene, which means they do things that prevent them from getting a good night’s sleep.

“These include drinking coffee or too much alcohol late at night, having a bedroom that is too hot or too cold, or having upsetting conversations before going to bed.”

Previous studies show that poor sleep can cause higher levels of stress hormones and raised inflammatory activity, which can both accelerate the progress of heart failure. Poor sleep is also related to mental distress, which could in turn affect health and lead to more hospital visits.

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