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Scand J Caring Sci. 2019 Mar 13. doi: 10.1111/scs.12672. [Epub ahead of print]

Sleepless nights and sleepy days: a qualitative study exploring the experiences of patients with chronic heart failure and newly verified sleep-disordered breathing.

Author information

1
Department of Cardiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
2
Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.
3
Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
4
Department of Cardiothoracic Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
5
Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
6
School of Health Sciences, Jönköping University, Jönköping, Sweden.
7
Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden.

Abstract

BACKGROUND:

Sleep-disordered breathing, including obstructive sleep apnoea and central sleep apnoea, is a common disorder among patients with chronic heart failure. Obstructive sleep apnoea is often treated with continuous positive airway pressure, but central sleep apnoea lacks a clear treatment option. Knowledge of how sleep-disordered breathing is experienced (e.g. difficulties and care needs) and handled (e.g. self-care actions) by the patients is limited, but needed, to provide patient-centred care.

AIM:

To explore how newly verified sleep-disordered breathing is experienced by patients with chronic heart failure.

METHODS:

Data were collected through semi-structured interviews and analysed with qualitative content analysis. Seventeen participants (14 men, three women), mean age 60 years (range 41-80) diagnosed with chronic heart failure and objectively verified sleep-disordered breathing (nine obstructive, seven central and one mixed) were strategically selected from heart failure outpatient clinics at two Norwegian university hospitals.

RESULTS:

Patients with chronic heart failure and newly verified sleep-disordered breathing (SDB) described experiences of poor sleep that had consequences for their daily life and their partners. Different self-care strategies were revealed, but they were based on 'common sense' and were not evidence-based. The awareness of having SDB was varied; for some, it gave an explanation to their trouble while others were surprised by the finding.

CONCLUSION:

Patients with chronic heart failure and sleep-disordered breathing experienced reduced sleep quality, influencing their daily life. Possible underlying causes of disrupted sleep, such as sleep-disordered breathing, should be identified to establish proper patient-centred treatment strategies. There is a need for new strategies to approach patients with chronic heart failure (i.e. those with central sleep apnoea) who are not subject to continuous positive airway pressure treatment for their sleep-disordered breathing.

KEYWORDS:

chronic heart failure; patient experience; qualitative content analysis; sleep apnoea; sleep-disordered breathing

PMID:
30866061
DOI:
10.1111/scs.12672

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