Journal of Artificial Organs

, Volume 21, Issue 3, pp 278–284 | Cite as

Sleep and self-care correlates before and after implantation of a left-ventricular assist device (LVAD)

  • Jesus M. Casida
  • Jean E. Davis
  • Francis D. Pagani
  • James E. Aikens
  • Celeste Williams
  • James J. Yang
Original Article Artificial Heart (Clinical)


The impact of sleep on LVAD patients’ self-care behaviors is unknown. This study examined the patterns and changes of patients sleep quality (SQ), daytime sleepiness (DS), instrumental activities of daily living (IADL), and self-care capability (SCC) before and after LVAD. In addition, the relationships among these variables were explored. This observational study consisted of 38 subjects from two VAD Centers in Michigan. The subjects completed self-reported demographics and psychometrically sound SQ, DS, IADL, and SCC questionnaires before LVAD implant and at 1, 3, and 6 months after implant. Data were analyzed using descriptive statistics, linear mixed models, and partial least square models. Subjects (mean age, 56.3 ± 10.3 years) were predominantly white (63%), male (68%), married (60%), and living with caregivers (92%). Over 70% had axial flow LVADs implanted as bridge-to-transplant (55%). Subjects’ SQ was poor throughout the study period, along with high normal-to-excessive levels of DS. Problems with IADL before implant were significantly reduced at 1 through 6 months after implant. SCC ranged from “good” to “excellent” before and after implant. Significant relationships between SQ and IADL (β = 0.43, p < 0.01) and DS and SCC (β = − 0.62, p < 0.01) were found. In conclusion, poor SQ and high degrees of DS were prevalent before and up to 6 months after LVAD implant. The data inferred that the improvement in IADL was associated with an improvement in SQ. Research is needed to clarify the negative impact of DS on SCC and explain the contributions of caregivers on patients’ SCC over time.


Ventricular assist devices Mechanical circulatory support Sleep Self-care Instrumental activities of daily living 



Funds were received from Robert Wood Johnson Foundation Nurse Faculty Scholars Program (Grant ID # 66525).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© The Japanese Society for Artificial Organs 2018

Authors and Affiliations

  • Jesus M. Casida
    • 1
  • Jean E. Davis
    • 2
  • Francis D. Pagani
    • 3
  • James E. Aikens
    • 4
  • Celeste Williams
    • 5
  • James J. Yang
    • 6
  1. 1.University of Michigan School of NursingAnn ArborUSA
  2. 2.Barnes-Jewish College Goldfarb School of NursingSt. LouisUSA
  3. 3.University of Michigan Medical School and Michigan Medicine, Frankel Cardiovascular CenterAnn ArborUSA
  4. 4.University of Michigan Medical SchoolAnn ArborUSA
  5. 5.Henry Ford HospitalDetroitUSA
  6. 6.University of Michigan School of NursingAnn ArborUSA

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