0881 Insomnia Is Related To Self-care In People With Stable Heart Failure

Abstract

Abstract Insomnia is common among patients with heart failure (HF) who must perform self-care to manage their health. Poor sleep may negatively affect self-care. The purpose was to describe the associations between insomnia severity, sleep characteristics, sleep-related cognitions, and self-care among patients with stable HF who had insomnia. We conducted an analysis of baseline data for an ongoing randomized controlled trial of cognitive behavioral therapy for insomnia (CBT-I) among people with HF. Included participants had stable chronic HF, scores gt 7 on the Insomnia Severity Index (ISI) and were 18 years of age or older; patients with untreated sleep apnea were excluded. Participants completed the Self-Care of Heart Failure Index (SCHFI), ISI, Pittsburgh Sleep Quality Index (PSQI), Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS), Sleep Disturbance Questionnaire (SDQ), the PROMIS Sleep Impairment Scale, and the Epworth Sleepiness Scale (ESS). We conducted correlational analyses. The sample included 77 HF patients [(M age = 60.63 (12.51) years; n = 44 (57.14%)] male; n = 51 (63%) white]. Overall, SCHFI scores were less than 70, indicating inadequate self-care: Total SCHFI [M = 65.04 (15.61)]; Self-care maintenance (SCM) [M = 65.49 (16.52)], Self-care management [M =55.38 (21.13)], and Self-care confidence [M = 67.90 (20.31)]. Higher insomnia severity (r = -.35, p = .002), poorer sleep quality (r = .22, p = .08), and prolonged sleep onset latency (r = -.43, p = .004), but not sleep duration or efficiency, were associated with SCM, but not the other SCHFI components. Higher total DBAS, DBAS insomnia consequences, and SDQ insomnia consequences were associated with poorer SCM (r = -.23, p = .04; r = -.29, p = .01; r = -.311, p = .006, respectively). Sleepiness and Sleep Related Impairment were not associated with self-care. Overall self-care maintenance is poor in patients with HF. Insomnia and sleep-related cognitions may contribute to self-care. Intervention such as cognitive behavioral therapy for insomnia that improve insomnia, sleep characteristics and sleep-related cognitions may also improve self-care maintenance in HF. R01NR016191.