644 Sleep Quality in Intensive Care Unit Patients with Advanced Heart Failure

Abstract Introduction Around 75% of Americans with heart failure (HF) report poor sleep quality, a much higher percentage than the general population. This is especially concerning since poor sleep quality is associated with poor cardiac event-free survival. Persons with HF are hospitalized often and between 10–51% of those hospitalized are admitted to an intensive care unit ICU. Poor sleep quality is a common complaint in ICU with over 50% of patients rating sleep quality as poor to very poor. The purpose of the study was to evaluate changes in sleep quality in persons with advanced HF who were admitted to an ICU. Methods Persons with advanced HF admitted to ICU were recruited into this pilot study (age 29–89). Using the Pittsburgh Sleep Quality Index, self-reported sleep quality was assessed at three time points: pre-admission, during hospitalization, and post-discharge. Scores greater than five indicated poor sleep quality. A Repeated Measures Analysis of Variance (RMANOVA) test compared means from the same participant over time for sleep quality (N=22). Results At baseline, 93% of participants reported poor sleep, 90% during hospitalization, and 86% post-discharge. A significant difference among the three time points was found [F (2, 42) =5.341; p<.01]. The mean sleep quality score pre-admission was 11.77 and SD=3.69, during hospitalization M=12.27 and SD=3.65, and post-discharge M=9.32 and SD=4.56. The mean difference of sleep quality pre-admission and sleep quality during hospitalization was not significant. However, the mean difference of sleep quality pre-admission and sleep quality post-discharge was significant (Mean difference=2.46; p<.05). Also, a significant difference in sleep quality during hospitalization and post-discharge was found (Mean difference=2.96; p<.05). Conclusion The number of participants who reported poor sleep during hospitalization was much larger than previously reported in the literature. Also, participants reported significantly better sleep quality post-discharge than pre-admission and during hospitalization. Furthermore, this population may be vulnerable for poor sleep due to symptom severity prior to hospital admission, diuretic use, and poor sleep hygiene. Implementation of sleep hygiene strategies are needed during hospitalization to promote sleep and to teach sleep hygiene self-management. Support (if any):