BACKGROUND:Chronic insomnia is common among patients with heart failure (HF) and may contribute to fatigue and poor function. However, to date there have been no randomized controlled trials focused on treatment of insomnia or daytime symptoms in this population. OBJECTIVES: The purpose of this study was to examine the preliminary efficacy, feasibility, and acceptability of a self-management intervention (cognitive behavioral therapy [CBT-I]) for insomnia among patients with stable HF. METHODS: We conducted a pilot randomized controlled trial (RCT) in which patients with stable Class I-III HF (n = 25/52.1% women; mean age = 59 ± 14.8 years) were randomized in groups to CBT-I (n = 29) or an attention control condition (HF self-management with sleep hygiene; n = 19). Participants completed 2 weeks of wrist actigraphy, the insomnia severity index, and measures of fatigue, depression, sleepiness, and functional performance at baseline and follow-up. We computed the size of the effects on the dependent variables and used MANOVA to evaluate the effects of CBT-I on insomnia and fatigue. RESULTS: CBT-I was feasible and acceptable and had a statistically significant effect on insomnia and fatigue, while controlling for the effects of comorbidity and age. CONCLUSIONS: CBT-I has short-term efficacy as a treatment for chronic insomnia among patients with stable HF. Future studies are needed to address its sustained effects.
RCT Entities:
BACKGROUND:Chronic insomnia is common among patients with heart failure (HF) and may contribute to fatigue and poor function. However, to date there have been no randomized controlled trials focused on treatment of insomnia or daytime symptoms in this population. OBJECTIVES: The purpose of this study was to examine the preliminary efficacy, feasibility, and acceptability of a self-management intervention (cognitive behavioral therapy [CBT-I]) for insomnia among patients with stable HF. METHODS: We conducted a pilot randomized controlled trial (RCT) in which patients with stable Class I-III HF (n = 25/52.1% women; mean age = 59 ± 14.8 years) were randomized in groups to CBT-I (n = 29) or an attention control condition (HF self-management with sleep hygiene; n = 19). Participants completed 2 weeks of wrist actigraphy, the insomnia severity index, and measures of fatigue, depression, sleepiness, and functional performance at baseline and follow-up. We computed the size of the effects on the dependent variables and used MANOVA to evaluate the effects of CBT-I on insomnia and fatigue. RESULTS: CBT-I was feasible and acceptable and had a statistically significant effect on insomnia and fatigue, while controlling for the effects of comorbidity and age. CONCLUSIONS: CBT-I has short-term efficacy as a treatment for chronic insomnia among patients with stable HF. Future studies are needed to address its sustained effects.
Authors: Clyde W Yancy; Mariell Jessup; Biykem Bozkurt; Javed Butler; Donald E Casey; Mark H Drazner; Gregg C Fonarow; Stephen A Geraci; Tamara Horwich; James L Januzzi; Maryl R Johnson; Edward K Kasper; Wayne C Levy; Frederick A Masoudi; Patrick E McBride; John J V McMurray; Judith E Mitchell; Pamela N Peterson; Barbara Riegel; Flora Sam; Lynne W Stevenson; W H Wilson Tang; Emily J Tsai; Bruce L Wilkoff Journal: Circulation Date: 2013-06-05 Impact factor: 29.690
Authors: Anne M Fink; Rosalia C Gonzalez; Tadeusz Lisowski; Maria Pini; Giamila Fantuzzi; Wayne C Levy; Mariann R Piano Journal: J Card Fail Date: 2012-09 Impact factor: 5.712
Authors: Rachel Manber; Jack D Edinger; Jenna L Gress; Melanie G San Pedro-Salcedo; Tracy F Kuo; Tasha Kalista Journal: Sleep Date: 2008-04 Impact factor: 5.849
Authors: Michael Littner; Clete A Kushida; W McDowell Anderson; Dennis Bailey; Richard B Berry; David G Davila; Max Hirshkowitz; Sheldon Kapen; Milton Kramer; Daniel Loube; Merrill Wise; Stephen F Johnson Journal: Sleep Date: 2003-05-01 Impact factor: 5.849
Authors: Nancy S Redeker; Andrea K Knies; Christopher Hollenbeak; H Klar Yaggi; John Cline; Laura Andrews; Daniel Jacoby; Anna Sullivan; Meghan O'Connell; Joanne Iennaco; Lisa Finoia; Sangchoon Jeon Journal: Contemp Clin Trials Date: 2017-01-31 Impact factor: 2.226
Authors: Yong K Choi; George Demiris; Shih-Yin Lin; Sarah J Iribarren; Carol A Landis; Hilaire J Thompson; Susan M McCurry; Margaret M Heitkemper; Teresa M Ward Journal: J Clin Sleep Med Date: 2018-10-15 Impact factor: 4.062
Authors: Nancy S Redeker; Samantha Conley; George Anderson; John Cline; Laura Andrews; Vahid Mohsenin; Daniel Jacoby; Sangchoon Jeon Journal: Behav Sleep Med Date: 2018-11-21 Impact factor: 2.964
Authors: Nancy S Redeker; Sangchoon Jeon; Laura Andrews; John Cline; Vahid Mohsenin; Daniel Jacoby Journal: Behav Sleep Med Date: 2017-08-22 Impact factor: 2.964
Authors: Faith S Luyster; Lee M Ritterband; Susan M Sereika; Daniel J Buysse; Sally E Wenzel; Patrick J Strollo Journal: Behav Sleep Med Date: 2018-09-25 Impact factor: 2.964
Authors: Garrett Ash; Sangchoon Jeon; Samantha Conley; Andrea K Knies; Henry K Yaggi; Daniel Jacoby; Christopher S Hollenbeak; Sarah Linsky; Meghan O'Connell; Nancy S Redeker Journal: Behav Sleep Med Date: 2020-10-13 Impact factor: 3.492
Authors: Allison E Gaffey; Sangchoon Jeon; Samantha Conley; Daniel Jacoby; Garrett I Ash; Henry K Yaggi; Meghan O'Connell; Sarah J Linsky; Nancy S Redeker Journal: Behav Sleep Med Date: 2020-05-12 Impact factor: 2.964