An exploratory study of sleep quality, daytime function, and quality of life in patients with mechanical circulatory support.
OBJECTIVE
To identify and describe: (1) characteristics of sleep quality, daytime sleepiness, and quality of life (QOL) pre and post implantation of a left ventricular assist device (LVAD); (2) changes in sleep quality, daytime sleepiness, and QOL at baseline and 6 months post implant; and (3) relationships among the sleep quality, daytime sleepiness, and QOL variables.


METHODS
We employed an exploratory research design. Fifteen patients with continuous/non-pulsatile flow LVAD consented to partake in the study. However, only 12 patients completed the baseline and 6-month post-LVAD implant data. We used the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Minnesota Living with Heart Failure Questionnaire (MLHFQ) to measure study variables. Data were analyzed using IBM SPSS 19.0 software.


RESULTS
Patients reported worse sleep quality accompanied by daytime sleepiness particularly at baseline, and persisting up to 6 months post LVAD implant. A significant improvement in QOL was observed at 6 months post implant, but remained at poor levels. Correlations among sleep disturbance and daytime dysfunction components of PSQI and global daytime sleepiness (ESS) with QOL were strong (Pearson's correlations r >.60; p values < .05).


CONCLUSIONS
We report the first empirical data describing the characteristics and correlations among sleep quality, daytime sleepiness, and QOL in patients with LVADs. Our findings offer beginning evidence about the sleep-QOL connection in this population which warrants attention in clinical practice and research. Further research is required to clearly elucidate these phenomena in patients with mechanical circulatory support and other implantable artificial organs.
Wayne State University College of Nursing, Detroit, MI 48202, USA. jcasida@wayne.edu
Jesus M
JM
Casida
Robert J
RJ
Brewer
Cheryl
C
Smith
Jean E
JE
Davis
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D006353:Heart-Assist Devices / Q000009:adverse effects* / Q000523:psychology*; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D010865:Pilot Projects; D011788:Quality of Life; D012890:Sleep; D012893:Sleep Wake Disorders / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left