Sleepless nights and sleepy days: a qualitative study exploring the experiences of patients with chronic heart failure and newly verified sleep‐disordered breathing

• Published in: Scandinavian journal of caring sciences 2019-09, Vol.33 (3), p.750-759
• Main Authors: Gullvåg, Marianne, Gjeilo, Kari Hanne, Fålun, Nina, Norekvål, Tone M., Mo, Rune, Broström, Anders
• Format: Article
• Language: English
• Subjects: Activities of daily living; Adult; Aged; Aged, 80 and over; Beta blockers; chronic heart failure; Common sense; Content analysis; Female; Health risk assessment; Heart failure; Heart Failure - complications; Hospitals; Humans; Male; Middle Aged; Nursing; Obstructive sleep apnea; Outpatient clinics; patient experience; Patient-centered care; Patients; qualitative content analysis; Qualitative Research; Respiration; Self care; Sleep apnea; Sleep Apnea, Central - etiology; Sleep Apnea, Central - psychology; Sleep Apnea, Obstructive - etiology; Sleep Apnea, Obstructive - psychology; sleep apnoea; Sleep disorders; sleep-disordered breathing
• ISSN: 0283-9318; 1471-6712; 1471-6712
• DOI: 10.1111/scs.12672

Background Sleep‐disordered breathing, including obstructive sleep apnoea and central sleep apnoea, is a common disorder among patients with chronic heart failure. Obstructive sleep apnoea is often treated with continuous positive airway pressure, but central sleep apnoea lacks a clear treatment option. Knowledge of how sleep‐disordered breathing is experienced (e.g. difficulties and care needs) and handled (e.g. self‐care actions) by the patients is limited, but needed, to provide patient‐centred care. Aim To explore how newly verified sleep‐disordered breathing is experienced by patients with chronic heart failure. Methods Data were collected through semi‐structured interviews and analysed with qualitative content analysis. Seventeen participants (14 men, three women), mean age 60 years (range 41–80) diagnosed with chronic heart failure and objectively verified sleep‐disordered breathing (nine obstructive, seven central and one mixed) were strategically selected from heart failure outpatient clinics at two Norwegian university hospitals. Results Patients with chronic heart failure and newly verified sleep‐disordered breathing (SDB) described experiences of poor sleep that had consequences for their daily life and their partners. Different self‐care strategies were revealed, but they were based on ‘common sense’ and were not evidence‐based. The awareness of having SDB was varied; for some, it gave an explanation to their trouble while others were surprised by the finding. Conclusion Patients with chronic heart failure and sleep‐disordered breathing experienced reduced sleep quality, influencing their daily life. Possible underlying causes of disrupted sleep, such as sleep‐disordered breathing, should be identified to establish proper patient‐centred treatment strategies. There is a need for new strategies to approach patients with chronic heart failure (i.e. those with central sleep apnoea) who are not subject to continuous positive airway pressure treatment for their sleep‐disordered breathing.