SLEEP QUALITY AND CHARACTERISTICS OF PEOPLE WITH ACUTE CARDIOVASCULAR DISEASE

Abstract

BACKGROUND/PURPOSE Sleep is an important aspect of restoring the physical and mental health of cardiac inpatients. Interventions to improve sleep amongst hospitalized medical patients have been previously described. However, little is known about the sleep characteristics of people with acute cardiovascular disease (CVD). Our objective was to describe the sleep quality and characteristics of older adults with acute CVD. METHODS/RESULTS The sleep characteristics and quality of a cohort of people aged ≥ 60 years admitted to the cardiovascular intensive care unit or cardiovascular unit at the Jewish General Hospital, an academic tertiary hospital in Montréal, Québec, Canada, were recorded. Patients were outfitted with an ActiGraph GT9X Link Bluetooth Activity Monitor, which provides data on total sleep time, sleep efficiency, awakenings per sleep period, and number of sleep periods during daytime hours. Sleep/awake status was delineated by the validated Sadeh or Cole-Kripke sleep algorithms (Actilife, Actigraph; Pensacola, Florida). A sleep bout was an activity episode that the device records. A sleep period was the frequency of sleep episodes within a particular sleep bout. Sleep efficiency was defined as the number of sleep minutes divided by the total number of minutes the subject was in bed. Prior studies of adults in the outpatient setting considered >95% sleep efficiency as a “good” night of sleep. Health-related-quality of life was measured by the physical component summary and mental component summary scores of the Short-Form 36 scale at 1-month follow-up telephone call. There were 25 patients included in the analysis (75.8 ± 7.6 years old; N=13; 52.0% female). The most common admission diagnoses were acute coronary syndromes (N=6; 24.0%) and atrial fibrillation (N=5; 12.0%). Patients slept an average of 5.9 hours per sleep period recorded. The mean sleep efficiency of 94.5% ± 2.9 (range 89.6-100.0%). The mean awakenings per sleep period for patients were 4.8 with an overall mean awakening length of 21.9 minutes. One-fifth of sleep periods (N=37/172 (21.5%)) occurred during daytime hours. There was no association between sleep efficiency or duration of sleep periods with the physical component summary and mental component summary scores at 1-month (P>0.05). CONCLUSION/IMPLICATIONS FOR PRACTICE A cohort of older adults with acute CVD slept on average about 6 hours per sleep period with generally good sleep efficiency. Future studies can explore whether improving sleep quality and duration may improve clinical and patient-centered outcomes in people with acute CVD. Sleep is an important aspect of restoring the physical and mental health of cardiac inpatients. Interventions to improve sleep amongst hospitalized medical patients have been previously described. However, little is known about the sleep characteristics of people with acute cardiovascular disease (CVD). Our objective was to describe the sleep quality and characteristics of older adults with acute CVD. The sleep characteristics and quality of a cohort of people aged ≥ 60 years admitted to the cardiovascular intensive care unit or cardiovascular unit at the Jewish General Hospital, an academic tertiary hospital in Montréal, Québec, Canada, were recorded. Patients were outfitted with an ActiGraph GT9X Link Bluetooth Activity Monitor, which provides data on total sleep time, sleep efficiency, awakenings per sleep period, and number of sleep periods during daytime hours. Sleep/awake status was delineated by the validated Sadeh or Cole-Kripke sleep algorithms (Actilife, Actigraph; Pensacola, Florida). A sleep bout was an activity episode that the device records. A sleep period was the frequency of sleep episodes within a particular sleep bout. Sleep efficiency was defined as the number of sleep minutes divided by the total number of minutes the subject was in bed. Prior studies of adults in the outpatient setting considered >95% sleep efficiency as a “good” night of sleep. Health-related-quality of life was measured by the physical component summary and mental component summary scores of the Short-Form 36 scale at 1-month follow-up telephone call. There were 25 patients included in the analysis (75.8 ± 7.6 years old; N=13; 52.0% female). The most common admission diagnoses were acute coronary syndromes (N=6; 24.0%) and atrial fibrillation (N=5; 12.0%). Patients slept an average of 5.9 hours per sleep period recorded. The mean sleep efficiency of 94.5% ± 2.9 (range 89.6-100.0%). The mean awakenings per sleep period for patients were 4.8 with an overall mean awakening length of 21.9 minutes. One-fifth of sleep periods (N=37/172 (21.5%)) occurred during daytime hours. There was no association between sleep efficiency or duration of sleep periods with the physical component summary and mental component summary scores at 1-month (P>0.05). A cohort of older adults with acute CVD slept on average about 6 hours per sleep period with generally good sleep efficiency. Future studies can explore whether improving sleep quality and duration may improve clinical and patient-centered outcomes in people with acute CVD.