认知行为疗法治疗失眠随机对照试验中慢性心力衰竭成人的睡眠健康表型。

IF 3.4 2区 医学 Q2 CLINICAL NEUROLOGY
Sleep Health Pub Date : 2024-12-01 Epub Date: 2024-10-30 DOI:10.1016/j.sleh.2024.09.006
Sangchoon Jeon, Samantha Conley, Meghan O'Connell, Zequan Wang, Nancy S Redeker
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引用次数: 0

摘要

背景:睡眠质量差会对心力衰竭患者的健康造成不利影响。然而,研究仅限于孤立的睡眠特征:评估认知行为疗法治疗失眠或注意力控制后睡眠健康表型的变化,以及睡眠健康表型、症状、压力、功能表现、急诊就诊和住院之间的关联:对认知行为疗法治疗心力衰竭成人失眠症的随机对照试验进行二次分析。我们测量了基线和干预后 3、6、12 个月的睡眠(休息-活动节律、睡眠时间、质量和效率、失眠严重程度、白天嗜睡)、症状、认知能力、警觉性和 6 分钟步行距离,并收集了住院和急诊就诊情况。我们使用了 K-均值聚类分析、广义线性混合模型、广义估计方程和 Cox 比例危险模型:在 166 名参与者(平均年龄为 63.2 (SD=12.6) 岁;57% 为男性;23% 为纽约心脏协会 III/IV 级)中,基线时有四种睡眠健康表型("睡眠不稳定"(15%)、"睡眠时间短"(39%)、"睡眠效率低"(25%)和 "睡眠良好"(21%))。最健康的表型与最低的疲劳度相关。从治疗前到治疗后,最健康睡眠组的参与者比例有所增加。低嗜睡(p = .0188)和稳健的昼夜节律商数(p = .007)预示着向最健康表型的转变。基线时最差的睡眠表型预测了住院时间和急诊就诊时间(危险比为0.35-0.60):结论:睡眠表型可预测心力衰竭的预后。结论:睡眠表型可预测心力衰竭的预后,针对表型的定制干预措施可能比关注单一睡眠特征的方法更有效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Phenotypes of sleep health among adults with chronic heart failure in a randomized controlled trial of cognitive behavioral therapy for insomnia.

Background: Poor sleep contributes to adverse health in heart failure. However, studies are limited to isolated sleep characteristics.

Purposes: To evaluate changes in sleep health phenotypes after cognitive behavioral therapy for insomnia or attention control and associations between sleep health phenotypes, symptoms, stress, functional performance, and emergency department visits and hospitalizations.

Methods: Secondary analysis of a randomized controlled trial of cognitive behavioral therapy for insomnia among adults with heart failure. We measured sleep (rest-activity rhythms, sleep duration, quality, and efficiency, insomnia severity, daytime sleepiness), symptoms, cognitive ability, vigilance, and 6-minute walk distance at baseline and 3-, 6-, and 12-month postintervention and collected hospitalizations and emergency department visits. We used K-means cluster analysis and generalized linear mixed models, generalized estimating equations, and Cox proportional hazard models.

Results: Among 166 participants (M age=63.2 (SD=12.6) years; 57% male; 23% New York Heart Association Class III/IV), there were four sleep health phenotypes ("Unstable Sleep" (15%); "Short Sleep" (39%); "Low Sleep Efficiency" (25%); and "Good Sleep" (21%)) at baseline. The healthiest phenotype was associated with the lowest fatigue. The proportions of participants in the healthiest sleep group increased from pre- to post-treatment. Low sleepiness (p = .0188) and a robust circadian quotient (p = .007) predicted transition to the healthiest phenotype. The poorest sleep phenotype at baseline predicted time to hospitalizations and emergency department visits (hazard ratios 0.35-0.60) after adjusting for covariates.

Conclusion: Sleep phenotypes predict heart failure outcomes. Tailored interventions targeting phenotypes may be more effective than approaches that focus on single sleep characteristics.

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来源期刊
Sleep Health
Sleep Health CLINICAL NEUROLOGY-
CiteScore
6.30
自引率
9.80%
发文量
114
审稿时长
54 days
期刊介绍: Sleep Health Journal of the National Sleep Foundation is a multidisciplinary journal that explores sleep''s role in population health and elucidates the social science perspective on sleep and health. Aligned with the National Sleep Foundation''s global authoritative, evidence-based voice for sleep health, the journal serves as the foremost publication for manuscripts that advance the sleep health of all members of society.The scope of the journal extends across diverse sleep-related fields, including anthropology, education, health services research, human development, international health, law, mental health, nursing, nutrition, psychology, public health, public policy, fatigue management, transportation, social work, and sociology. The journal welcomes original research articles, review articles, brief reports, special articles, letters to the editor, editorials, and commentaries.
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