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CC BY-NC-ND 4.0 · Sleep Sci 2021; 14(01): 11-18
DOI: 10.5935/1984-0063.20190154
Original Article

Sleep quality among cardiac patients on follow up at Jimma Medical Center, southwestern Ethiopia

Authors

  • Yared Getahun

    1   Jimma University, Institute of Health, Faculty of Medical Science, School of Medicine, Department of Internal Medicine - Jimma - Oromia - Ethiopia.

  • Wondu Reta Demissie

    2   Jimma University, Institute of Health, Faculty of Medical Science, School of Medicine, Department of Biomedical Sciences - Jimma - Oromia - Ethiopia.

  • Hiwot Amare

    1   Jimma University, Institute of Health, Faculty of Medical Science, School of Medicine, Department of Internal Medicine - Jimma - Oromia - Ethiopia.
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Introduction Chronic heart failure is associated with changes in sleep pattern and affects quality of sleep among patients with heart failure. Poor sleep has a negative impact on the patients’ quality of life, furthermore it compromises cognition and one’s self-care practice. Though, factors affecting sleep among heart failure patients have been investigated in developed world, there are limited studies in regards to it in developing countries like Ethiopia.

Objective The aim of the study is to assess the level of sleep quality and associated factors among heart failure patients who are on follow up at Jimma Medical Center (JMC).

Material and Methods Hospital based cross sectional study was employed among the total sample of 111 chronic heart failure patients admitted to medical ward and having follow up at cardiac center of JMC. The data was collected from April 1 - April 30, 2019 through face-to-face interview by using structured questionnaire. Pittsburg Sleep Quality Index (PSQI) was applied to assess sleep quality. PSQI score <5 refers to good sleep quality. Data was checked, cleaned for possible errors, entered into Epidata version 4.3.1 and finally exported to SPSS version 20 for further analysis. Appropriate statistical analyses (cross tabulation and logistic regression) were applied. A p value less than 0.05 was used to declare statistical significance.

Results The mean age was 49±14 that ranges from 20-89 years by which majority of them 34 (30.6%) belongs to interval age of 35-44 years. The mean of PSQI score was 4.9±2.79 that ranges from 1-17 scores. Majority of the cardiac patients [69(62.2%)] were considered as having good sleep status (PSQI score <5) while the remaining 42 (37.8%) were considered as poor sleepers with PSQI score >5. Two variables (age of patients more than 65 years and presence of comorbidity) were identified as associated factors with poor sleep quality having P-value less than 0.05 and specific AOR with 95%CI of 4.087 (2.013-8.612) and 3.042 (1.074-8.619), respectively.

Conclusion Poor sleep quality is common in heart failure patients. Age >65 years and comorbidities are predictors of poor sleep quality in these patients.

Sleep Quality - PSQI - Cardiac Patients - JMC - Ethiopia - Associated Factors

FUNDING

The authors did this study by their own cost.


AUTHORS’ CONTRIBUTIONS

YG - involved in research concept and design, collection and/or assembly of data, data analysis and interpretation, writing the article, critical revision of the article, final approval of article and statistical analysis. WR - involved in research data analysis and interpretation, writing the manuscript, critical revision of the article, final approval of article and statistical analysis. HA - involved in research concept and design, critical revision of the article, final approval of article.


COMPETING INTERESTS

The authors declare that they have no competing interests.


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Publication History

Received: 05 February 2020

Accepted: 13 May 2020

Article published online:
30 November 2023

© 2023. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • REFERENCES

  • 1 Wintrobe MM, Thorn GW, Adams R, Braunwald E, Isselbacher KJ, Petersdorf RG. Harrison’s principles of internal medicine. New York: McGraw-Hill; 1974.
  • 2 Roger VL. Epidemiology of heart failure. Circ Res. 2013 Aug;113(6):646-59.
  • 3 Libby P, Bonow RO, Mann DL, Zipes DP. Braunwald’s heart disease: a textbook of cardiovascular medicine. Amsterdam: Elsevier Health Sciences; 2007. v. 2.
  • 4 Bui AL, Horwich TB, Fonarow GC. Epidemiology and risk profile of heart failure. Nat Rev Cardiol. 2011 Jan;8(1):30-41.
  • 5 Dijk DJ, Cajochen C. Melatonin and the circadian regulation of sleep initiation, consolidation, structure, and the sleep EEG. J Biol Rhythms. 1997 Dec;12(6):627-35.
  • 6 Dijk DJ, Czeisler CA. Contribution of the circadian pacemaker and the sleep homeostat to sleep propensity, sleep structure, electroencephalographic slow waves, and sleep spindle activity in humans. J Neurosci. 1995 May;15(5 Pt 1):3526-38.
  • 7 Kecklund G, Axelsson J. Health consequences of shift work and insufficient sleep. BMJ. 2016 Nov;355:i5210.
  • 8 Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989 May;28(2):193-213.
  • 9 Carpenter JS, Andrykowski MA. Psychometric evaluation of the Pittsburgh Sleep Quality Index. J Psychosom Res. 1998 Jul;45(1):5-13.
  • 10 Foley D, Ancoli-Israel S, Britz P, Walsh J. Sleep disturbances and chronic disease in older adults: results of the 2003 National Sleep Foundation Sleep in America Survey. J Psychosom Res. 2004 May;56(5):497-502.
  • 11 Parker KP, Dunbar SB. Sleep and heart failure. J Cardiovasc Nurs. 2002;17(1):30-41.
  • 12 Erickson VS, Westlake CA, Dracup KA, Woo MA, Hage A. Sleep disturbance symptoms in patients with heart failure. AACN Adv Crit Care. 2003;14(4):477-87.
  • 13 Dos MS, Barbosa RL. Factors associated to sleep pattern in heart failure patients. Rev Esc Enferm USP. 2011 Oct;45(5):1105-12.
  • 14 Santos MA, Guedes ES, Barbosa RL, Cruz DA. Sleeping difficulties reported by patients with heart failure. Rev Lat Am Enfermagem. 2012 Jul/Aug;20(4):644-50.
  • 15 Chen HM, Clark AP. Sleep disturbances in people living with heart failure. J Cardiovasc Nurs. 2007 May/Jun;22(3):177-85.
  • 16 Lanfranchi PA, Somers VK. Sleep-disordered breathing in heart failure: characteristics and implications. Respir Physiol Neurobiol. 2003 Jul;136(2-3):153-65.
  • 17 Redeker NS. Sleep-disordered breathing in patients with heart failure: an update. Yale University School of Nursing; 2005:15-24.
  • 18 Birhanu TE, Getachew B, Gerbi A, Dereje D. Prevalence of poor sleep quality and its associated factors among hypertensive patients on follow up at Jimma University Medical Center. J Hum Hypertens. 2020 Mar 3; [Epub ahead of print].
  • 19 Smyth C. The Pittsburgh sleep quality index (PSQI). J Gerontol Nurs. 1999 Dec;25(12):10-1.
  • 20 Salahuddin M, Maru TT, Kumalo A, Pandi-Perumal SR, Bahammam AS, Manzar MD. Validation of the Pittsburgh Sleep Quality Index in community dwelling Ethiopian adults. Health Qual Life Outcomes. 2017 Mar;15(1):58.
  • 21 Abebe A, Temamen T, Fikadu B, Gugsa N. Perceived sleep quality of heart failure patients at Jimma university specialized hospital (JUSH) chronic follow up clinic south west Ethiopia, 2015. J Health Med Nurs. 2015 Oct;20:34-44.
  • 22 Chen HM, Clark AP, Tsai LM, Chao YFC. Self-reported sleep disturbance of patients with heart failure in Taiwan. Nurs Res. 2009 Jan/ Feb;58(1):63-71.
  • 23 Wang TJ, Lee SC, Tsay SL, Tung HH. Factors influencing heart failure patients’ sleep quality. J Adv Nurs. 2010 Aug;66(8):1730-40.
  • 24 Moradi M, Mehrdad N, Nikpour S, Haghani H, Aalaa M, Sanjari M, et al. Sleep quality and associated factors among patients with chronic heart failure in Iran. Med J Islam Repub Iran. 2014 Dec;28:149.
  • 25 Wong WS, Fielding R. Prevalence of insomnia among Chinese adults in Hong Kong: a population-based study. J Sleep Res. 2011 Mar;20(1 Pt1):117-26.
  • 26 Ohayon MM, Sagales T. Prevalence of insomnia and sleep characteristics in the general population of Spain. Sleep Med. 2010 Dec;11(10):1010-8.
  • 27 Bittencourt LRA, Santos-Silva R, Taddei JA, Andersen ML, Mello MT, Tufik S. Sleep complaints in the adult Brazilian population: a national survey based on screening questions. J Clin Sleep Med. 2009 Oct;5(5):459-63.
  • 28 Gau FY, Chen XP, Wu HY, Lin M, Chao YFC. Sleep-related predictors of quality of life in the elderly versus younger heart failure patients: a questionnaire survey. Int J Nurs Stud. 2011;48(4):419-28.
  • 29 Broström A, Strömberg A, Dahlström U, Fridlund B. Sleep difficulties, daytime sleepiness, and health-related quality of life in patients with chronic heart failure. J Cardiovasc Nurs. 2004 Jul/Aug;19(4):234-42.
  • 30 Redeker NS, Stein S. Characteristics of sleep in patients with stable heart failure versus a comparison group. Heart Lung. 2006 Jul/Aug;35(4):252-61.
  • 31 Zeighami MS, Shahparian M. Evaluation of sleep problems and its associated factors in male patients with systolic heart failure. QOM Univ Med Sci J. 2013;6(4):64-73.
  • 32 Skobel E, Norra C, Sinha A, Breuer C, Hanrath P, Stellbrink C. Impact of sleep-related breathing disorders on health-related quality of life in patients with chronic heart failure. Eur J Heart Fail. 2005;7(4):505-11.