Inadequate Sleep Doubles Hospitalization Risk in Heart Failure Patients

A new study finds that poor and disturbed sleep in heart failure patients is linked with a higher risk of hospitalizations.

The study, based on the analysis of 500 patients, was led by researchers at the University Hospital of Linkoping, Sweden. This is one of the first studies to highlight the association between poor sleep and the two-fold increased risk of hospitalization in heart failure patients. 

"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 hospitalizations. Our study shows that some patients with heart failure have chronic sleep problems and this more than doubles their risk of unplanned hospitalizations. We need to ask all our heart failure patients whether they sleep well and if not, find out why," study lead Dr. Peter Johansson said in a news release.

This study was based on 499 patients hospitalized after heart failure. The participants were a part of Co-ordinating study evaluating Outcomes of Advising and Counseling in Heart failure (COACH). Information on physical functioning, mental health and sleep was collected during the initial hospitalization.  Using the question 'Was your sleep restless?' the researchers assessed the sleep problems.

After a gap of 12 months, researchers evaluated the number and cause of unplanned hospitalization during the follow up study and again assessed sleep among the participants.

Researchers found that nearly 43 percent of the participants had sleep problems during the initial hospitalization discharge. Over 30 percent of them had continued sleep problems at 12 months.  Those with continued sleep problems were two times more likely to be hospitalized during the follow-up study when compared to those without any sleep problems. There was a two-fold increased risk for all-cause hospitalization and for cardiovascular hospitalizations. 

Amongst the 284 patients without sleep problems initially, nearly 14 percent developed sleep problem during the follow up period.  These patients were more vulnerable to be hospitalized for cardiovascular problems than those without any sleep problems.

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. 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."

The study was presented at the EuroHeartCare 2014.