Associations of Insomnia Symptoms With Cognition in Persons With Heart Failure

Although cognitive impairment is common among persons with heart failure and negatively impacts self-care, hospitalization, and mortality, the associations between cognitive impairment and insomnia symptoms are not clearly understood. The purpose of this study was to explore these associations and examine if they are maintained after adjusting for relevant sociodemographic, clinical, and lifestyle factors. Guided by the Neurocognitive model of insomnia and sleep and the self-care conceptual model, a cross-sectional data analysis using parametric testing was conducted on the Health and Retirement Study wave 2016. Difficulty initiating sleep and early morning awakening, but not difficulty maintaining sleep were significantly associated with poorer cognitive performance in the bivariate and multivariate analysis. Our results are suggestive of different phenotypes of insomnia symptoms that may have different associations with cognition in persons with heart failure. Further research using objective measurements of insomnia symptoms and detailed neuropsychiatric testing of cognition is needed to confirm this conclusion.

Automated summary

Although cognitive impairment is common in individuals with heart failure and has negative impacts, the connection between cognitive impairment and insomnia symptoms is not well understood. This study examined the associations and found that difficulty initiating sleep and early morning awakening were significantly linked to poorer cognitive performance in heart failure patients. Further research utilizing objective measures of insomnia symptoms and detailed cognitive testing is necessary to confirm these findings.