Effectiveness of Non-Pharmacological Interventions on Sleep and Health-Related Quality of Life of Patients with Heart Failure

Santos, Mariana Alvina

Purpose:

Investigate the feasibility of an RCT of non-pharmacological interventions on sleep and quality of life of patients with HF and additionally test the effect of sleep hygiene therapy, phototherapy and combination therapy (phototherapy +sleep hygiene) sleep compared with guidance on disease management.

Methods: This was a pilot of a blinded randomized clinical trial in which 32 subjects (women: 59.4%; mean age: 55.4 (SD=10.4) years, NYHA II-III: 90.7%) were randomized to three intervention groups (phototherapy, measures of sleep hygiene and combined therapy) and a control group (guidance on management of the disease and medications) to test the effectiveness of sleep interventions in sleep (Pittsburg Sleep Quality Index) and health-related quality of life (Minnesota Living with Heart Failure Questionnaire) improvement. Participants were assessed at baseline, 4^th, 8^th, 12^th and 24^th weeks of follow up. Outcomes were analyzed longitudinally by repeated measures-ANOVA. An intention-to-treat analysis was conducted.

Results: Statistically significant improvement were found in both intervention and control groups in sleep pattern by the 12^th week (F: 63.09, p<0,001) and 24^th week (F:64.06, p<0,001), and in related-health quality of life by the 12^th week (F: 13.81, p<0,001) and 24^th week (F:15.02, p<0,001). No statistically significant difference was found in sleep and health-related quality of life improvement between groups.

Conclusion:

Measures of sleep hygiene and phototherapy, isolated or combined with each other, and education about the management of the symptoms of the disease have a similar positive effect on sleep and quality of life of patients with HF. Studies with larger samples are needed.