1. Use and Efficacy of Cognitive-Behavioral Strategies for Sleep Disturbance in Heart Failure Patients
Ali Rushmer BSN Student, Sarah Loring BSN Student, Heidi Lindroth RN, PhD Student,
Xiaochen Chen PhD, RN, Kelsey Melah BSc, Lisa Bratzke PhD, RN, ANP-BC, FAHA, Kristine Kwekkeboom PhD, RN
Background
Methods
Sample: 20 adults with heart failure
experiencing pain, dyspnea, fatigue, and
sleep disturbance. Three participants
consented but provided no data.
Results
Discussion & Conclusion
• Frequently used CB strategies included sleep focused guided imagery and
nature sound recordings (rain, waves).
• Sleep disturbance severity ratings decreased from pre- to post-intervention at
week 4; but differences at other time points were not statistically significant.
• Other strategies to support sleep may include medications, behavioral sleep
routines, exercise, diet changes, and CPAP.
• More research with a larger sample is needed to demonstrate efficacy of CB
strategies for palliation of HF symptoms.
Purpose
• Sleep disturbance is one of the most common symptoms experienced by
patients with heart failure (HF) and can significantly disrupt quality of life. 1
• Heart failure management guidelines do not address symptom palliation and
make no recommendations for management of sleep disturbance.
• Cognitive behavioral (CB) strategies such as relaxation and guided imagery
have been shown to improve sleep in other chronic health conditions and offer a
promise as treatment for sleep disturbance in HF. 2
Data from a feasibility study of a CB symptom management intervention was
analyzed:
•To describe use of CB strategies and pre-post changes in sleep disturbance
•To identify other supportive measures taken to improve sleep
Sample Characteristics
(N=17) n (%)
Age M=58 (SD=14)
Gender
Female 10 (59%)
Race
Caucasian
Black or African Am.
Other
14 (82%)
2 (12%)
1 (6%)
Education
High School
Some College
College Degree
3 (18%)
6 (35%)
8 (47%)
Heart Failure Class
Class 2
Class 3
Not reported
6 (35%)
6 (35%)
5 (30%)
*p=.032
Design: One group repeated
measures feasibility trial.
Intervention: Participants received
training and recommendations for
daily use of 13 audio-recorded CB
strategies (relaxation, distraction, and
guided imagery) for a period of 12
weeks.
Instruments:
Demographic & Clinical
Characteristics: Collected through
self-report and medical record review.
Sleep Disturbance Severity: Worst
sleep disturbance was rated on a 0-10
numeric rating scale at baseline and
weeks 2-, 4-, 6-, & 12.
Weekly Symptom Diary: Log of CB
strategies used, and steps taken to
manage sleep disturbance.