Gharzeddine Rida, McCarthy Margaret M, Yu Gary, Dickson Victoria Vaughan
J Cardiovasc Nurs. 2021;36(4):374-384. doi: 10.1097/JCN.0000000000000719.
BACKGROUND/OBJECTIVE: Insomnia and insomnia symptoms are highly prevalent in persons with heart failure (HF), and they are associated with several untoward outcomes. The purpose of this integrative review is to describe the correlates, predictors, and outcomes of insomnia and insomnia symptoms in persons with HF.
Using integrative review methods, an extensive electronic search of 5 databases was conducted for the period of 2000-2019. Sixteen studies were identified that met the inclusion criteria for review and investigated insomnia or insomnia symptoms in HF.
Various sociodemographic factors, chronic comorbidities, clinical factors, and cognitive-behavioral factors are correlates and predictors of insomnia and insomnia symptoms in persons with HF. Depression, fatigue, daytime sleepiness, poor self-reported physical functioning, decreased exercise capacity, cardiac events, and poor health-related quality of life are significant outcomes of insomnia and insomnia symptoms in persons with HF. The associations of insomnia and insomnia symptoms with age, sex, sleep-disordered breathing, and cognition were not consistent across all studies.
Larger studies with diverse age and race groups as well as longitudinal studies and designs that test mediation effects are needed to disentangle complex relationships between insomnia and insomnia symptoms and several of their potential predictors and correlates in HF.
背景/目的：失眠及失眠症状在心力衰竭（HF）患者中极为常见，且与多种不良后果相关。本整合性综述旨在描述HF患者失眠及失眠症状的相关因素、预测因素及后果。
采用整合性综述方法，对2000年至2019年期间的5个数据库进行了广泛的电子检索。共识别出16项符合纳入标准的研究，这些研究调查了HF患者的失眠或失眠症状。
各种社会人口学因素、慢性合并症、临床因素以及认知行为因素是HF患者失眠及失眠症状的相关因素和预测因素。抑郁、疲劳、日间嗜睡、自我报告的身体功能不佳、运动能力下降、心脏事件以及与健康相关的生活质量差是HF患者失眠及失眠症状的重要后果。在所有研究中，失眠及失眠症状与年龄、性别、睡眠呼吸障碍和认知之间的关联并不一致。
需要开展涵盖不同年龄和种族群体的更大规模研究，以及进行纵向研究和测试中介效应的设计，以厘清HF患者中失眠及失眠症状与其若干潜在预测因素和相关因素之间的复杂关系。
