Leg thermal therapy improved sleep structure and subjective sleep quality in chronic heart failure

Abstract

Introduction An increasing number of patients with chronic heart failure (CHF) is suffering from insomnia, which is also impairing their quality of life (QOL) and might worsen heart failure. Previous studies reported that sleep depth and sleep onset were strongly affected by body temperatures before sleeping. We developed a leg thermal therapy (LTT) in which we used infra-red radiation to heat lower legs and could increase core body temperatures by 0.4 ° C without any harmful hemodynamic changes in patients with CHF. We also found that the LTT was effective in improving the hemodynamics, vascular endothelial function, and reducing oxidative stress in patients with CHF. In present study, we evaluated the effects of the LTT on sleep quality in CHF from both subjective and objective sides. Materials and methods Fifteen inpatients with CHF (age: 53_}14 y.o., Male: 13, NYHA: II–III) underwent the LTT (45 ° C) for 15 min followed by 30 min insulation for 3 consecutive nights before sleep. For objective evaluation of the LTT on sleep fragmentations, we recorded type-2 polysomnography before the LTT and just after three days_f LTT. We assessed subjective sleep quality using the Oguri-Shirakawa-Azumi sleep inventory and St. Mary_fs Hospital sleep questionnaires every morning. We evaluated vascular endothelial function using flow-mediated vasodilation measurement in the early morning. Results Three consecutive nights protocol of the LTT showed significant decrease of sleep stage I, and the sum of sleep stage I and II (p Conclusion Three nights protocol of the LTT actually decreased light sleep and improved subjective sleep quality in patients with CHF. LTT had potential as a safety and complementary therapy that can improve sleep quality, QOL and prognosis in patients with CHF. Although the long term effects of LTT on sleep disturbance or prognosis on CHF remain to be investigated, current result suggests that the LTT could be used to improve QOL of CHF patients through improvement of their sleep quality.