Insomnia and Insomnia Symptoms in Persons With Heart Failure An Integrative Review

Background/Objective Insomnia and insomnia symptoms are highly prevalent in persons with heart failure (HF), and they are associated with several untoward outcomes. The purpose of this integrative review is to describe the correlates, predictors, and outcomes of insomnia and insomnia symptoms in persons with HF. Methods Using integrative review methods, an extensive electronic search of 5 databases was conducted for the period of 2000-2019. Sixteen studies were identified that met the inclusion criteria for review and investigated insomnia or insomnia symptoms in HF. Results Various sociodemographic factors, chronic comorbidities, clinical factors, and cognitive-behavioral factors are correlates and predictors of insomnia and insomnia symptoms in persons with HF. Depression, fatigue, daytime sleepiness, poor self-reported physical functioning, decreased exercise capacity, cardiac events, and poor health-related quality of life are significant outcomes of insomnia and insomnia symptoms in persons with HF. The associations of insomnia and insomnia symptoms with age, sex, sleep-disordered breathing, and cognition were not consistent across all studies. Conclusion Larger studies with diverse age and race groups as well as longitudinal studies and designs that test mediation effects are needed to disentangle complex relationships between insomnia and insomnia symptoms and several of their potential predictors and correlates in HF.

Automated summary

Insomnia and insomnia symptoms in persons with heart failure are associated with various sociodemographic, clinical, and cognitive-behavioral factors, and are linked to outcomes such as depression, fatigue, poor physical functioning, and decreased exercise capacity. However, more research, including larger and longitudinal studies, is needed to further understand the complex relationships between insomnia and potential predictors and correlates in heart failure.