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Correlates of cognition among people with chronic heart failure and insomnia

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

This study aimed to describe cognitive characteristics and their associations with demographic and clinical factors among adults with chronic heart failure (HF) and insomnia.

Methods

We performed a cross-sectional analysis of baseline data from the HeartSleep Study (NCT#02,660,385), a randomized controlled trial designed to evaluate the effects of cognitive-behavioral therapy for insomnia. Demographic characteristics and health history were obtained. We measured sleep characteristics with the Insomnia Severity Index, the PROMIS Sleep Disturbance Questionnaire, and wrist actigraphy. Sleepiness, stress, and quality of life were measured with validated questionnaires. Measures of cognition included frequency of lapses on the psychomotor vigilance test and the PROMIS cognitive abilities scale where ≥ 3 lapses and a score of ≤ 50, respectively, suggested impairment. These variables were combined into a composite score for multivariable analyses.

Results

Of a sample that included 187 participants (58% male; mean age 63.1 [SD = 12.7]), 77% had New York Heart Association class I or II HF and 66% had HF with preserved ejection fraction. Common comorbidities were diabetes (35%), hypertension (64%), and sleep apnea (54%). Impaired vigilant attention was associated with non-White race, higher body mass index, less education, and more medical comorbidities. Self-reported cognitive impairment was associated with younger age, higher body mass index, and pulmonary disease. On adjusted analysis, significant risk factors for cognitive impairment included hypertension (OR 1.94), daytime sleepiness (OR 1.09), stress (OR 1.08), and quality of life (OR 0.12).

Conclusions

Impaired cognition is common among people with chronic HF and insomnia and associated with hypertension, daytime sleepiness, stress, and poor quality of life.

Trial registration

ClinicalTrials.gov Identifier: Insomnia Self-management in Heart Failure; NCT#02,660,385.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

The National Institute of Nursing Research provided financial support in the form of R01NR016191 (SJ, MO, SL, SC, CSH, DJ, HKY, NSR), P20NR014126 (HKY, NSR), and UL1 TR001863 funding. JHG received financial support from ATS ASPIRE Fellowship and AASM Foundation Physician Scientist Award.

Author information

Authors and Affiliations

  1. Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA

    Jacqueline H. Geer, Daniel Jacoby & H. Klar Yaggi

  2. Yale School of Nursing, 400 West Campus Drive, Orange, CT, 06477, USA

    Sangchoon Jeon, Sarah Linsky & Nancy S. Redeker

  3. Schools of Nursing and Medicine, University of Connecticut, 231 Glenbrook Road, Unit 4026, Storrs Mansfield, CT, 06269, USA

    Meghan O’Connell & Nancy S. Redeker

  4. Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Samantha Conley

  5. Pennsylvania State University, Donald H. Ford Bldg, University Park, PA, 16802, USA

    Christopher S. Hollenbeak

Authors
  1. Jacqueline H. Geer
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  2. Sangchoon Jeon
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  3. Meghan O’Connell
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  4. Sarah Linsky
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  9. Nancy S. Redeker
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Corresponding author

Correspondence to Nancy S. Redeker.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Yale University Human Research Protection Program and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Geer, J.H., Jeon, S., O’Connell, M. et al. Correlates of cognition among people with chronic heart failure and insomnia. Sleep Breath 27, 1287–1296 (2023). https://doi.org/10.1007/s11325-022-02716-w

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  • DOI: https://doi.org/10.1007/s11325-022-02716-w

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