The effect of a supervised exercise training programme on sleep quality in recently discharged heart failure patients.
BACKGROUND
Sleep disturbances, including insomnia and sleep-disordered breathing, are a common complaint in people with heart failure and impair well-being. Exercise training (ET) improves quality of life in stable heart failure patients. ET also improves sleep quality in healthy older patients, but there are no previous intervention studies in heart failure patients.


OBJECTIVE
The aim of this study was to examine the impact of ET on sleep quality in patients recently discharged from hospital with heart failure.


METHODS
This was a sub-study of a multisite randomised controlled trial. Participants with a heart failure hospitalisation were randomised within six weeks of discharge to a 12-week disease management programme including exercise advice (n=52) or to the same programme with twice weekly structured ET (n=54). ET consisted of two one-hour supervised aerobic and resistance training sessions, prescribed and advanced by an exercise specialist. The primary outcome was change in Pittsburgh Sleep Quality Index (PSQI) between randomisation and week 12.


RESULTS
At randomisation, 45% of participants reported poor sleep (PSQI≥5). PSQI global score improved significantly more in the ET group than the control group (-1.5±3.7 vs 0.4±3.8, p=0.03). Improved sleep quality correlated with improved exercise capacity and reduced depressive symptoms, but not with changes in body mass index or resting heart rate.


CONCLUSIONS
Twelve weeks of twice-weekly supervised ET improved sleep quality in patients recently discharged from hospital with heart failure.
Internal Medicine and Aged Care, Royal Brisbane and Women's Hospital, Australia School of Exercise and Nutrition, Queensland University of Technology, Australia Jessica_Suna@health.qld.gov.au.
Jessica M
JM
Suna
Internal Medicine and Aged Care, Royal Brisbane and Women's Hospital, Australia School of Medicine, University of Queensland, Australia.
Alison
A
Mudge
School of Exercise and Nutrition, Queensland University of Technology, Australia.
Ian
I
Stewart
Queensland Institute of Medical Research, Australia.
Louise
L
Marquart
Queensland Institute of Medical Research, Australia.
Peter
P
O'Rourke
Internal Medicine and Aged Care, Royal Brisbane and Women's Hospital, Australia School of Exercise and Nutrition, Queensland University of Technology, Australia.
Adam
A
Scott
D000368:Aged; D000704:Analysis of Variance; D003266:Continuity of Patient Care; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D011788:Quality of Life; D011793:Queensland; D012016:Reference Values; D018570:Risk Assessment; D012890:Sleep / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000209:etiology / Q000534:rehabilitation*; D016896:Treatment Outcome
Exercise; heart failure; physical activity; sleep