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      Daytime and Nighttime Sleep Characteristics and Pain Among Adults with Stable Heart Failure

      , PhD, RN, FNP-BC, , PhD, APRN, FNP-BC, ACHPN, , PhD, , PhD, RN,

      The Journal of cardiovascular nursing

      heart failure, pain, sleep, sleep initiation and maintenance disorders, actigraphy, polysomnography

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          Abstract

          Background:

          Pain and sleep disturbance are common among patients with heart failure (HF) and are associated with symptom burden, disability, and poor quality of life. Little is known about the associations between specific sleep characteristics and pain in people with HF.

          Objective:

          Describe the relationships between nocturnal sleep characteristics, use of sleep medication, and daytime sleep characteristics and pain among people with HF.

          Methods:

          We conducted a cross-sectional study of stable HF participants. We administered the SF36 Bodily Pain Scale, Pittsburgh Sleep Quality Index, and Sleep Habits Questionnaire, and obtained 3 days of wrist actigraphy and one night of home unattended polysomnography. We conducted bivariate analyses and generalized linear models.

          Results:

          The sample included 173 participants [mean age= 60 years (SD 16.1), 65.3% (n= 113) male). Insomnia symptoms (p= .0010), sleep duration (p= .0010), poor sleep quality (p= .0153), use of sleep medications (p= .0170) and napping (p=.0029), and daytime sleepiness (p= .0094) were associated with increased pain. Patients with the longest sleep duration, who also had insomnia, had more pain (p= .0004), fatigue (p= .0028), daytime sleepiness (p= .0136), poorer sleep quality, (p< .0001) and took more sleep medications (p= .0029) than those without insomnia.

          Conclusions:

          Pain is associated with self-reported poor sleep quality, napping, daytime sleepiness, and use of sleep medication. The relationship between pain and sleep characteristics differs based on the presence of insomnia and sleep duration. Studies are needed to evaluate the causal relationships between sleep and pain and test interventions for these co-occurring symptoms.

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          Author and article information

          Contributors
          Role: Assistant Professor
          Role: Post-doctoral Fellow
          Role: Research Scientist
          Role: Term Professor of Nursing
          Journal
          8703516
          5022
          J Cardiovasc Nurs
          J Cardiovasc Nurs
          The Journal of cardiovascular nursing
          0889-4655
          1550-5049
          12 May 2019
          Sep-Oct 2019
          01 September 2020
          : 34
          : 5
          : 390-398
          Affiliations
          Yale School of Nursing Orange, CT
          Yale School of Medicine New Haven, CT
          Yale School of Nursing Orange, CT
          Yale School of Nursing Orange, CT
          Yale School of Nursing Orange, CT
          Author notes
          Contact author: Samantha Conley, 400 West Campus Dr., Orange, CT 06477, samantha.conley@ 123456yale.edu , 203-737-1754
          Article
          PMC6690780 PMC6690780 6690780 nihpa1529011
          10.1097/JCN.0000000000000593
          6690780
          31365442
          Categories
          Article

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