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Published in:

01-09-2009

Insomnia and chronic heart failure

Authors: Don Hayes Jr, Michael I. Anstead, Julia Ho, Barbara A. Phillips

Published in: Heart Failure Reviews | Issue 3/2009

Abstract

Insomnia is highly prevalent in patients with chronic disease including chronic heart failure (CHF) and is a significant contributing factor to fatigue and poor quality of life. The pathophysiology of CHF often leads to fatigue, due to nocturnal symptoms causing sleep disruption, including cough, orthopnea, paroxysmal nocturnal dyspnea, and nocturia. Inadequate cardiac function may lead to hypoxemia or poor perfusion of the cerebrum, skeletal muscle, or visceral body organs, which result in organ dysfunction or failure and may contribute to fatigue. Sleep disturbances negatively affect all dimensions of quality of life and is related to increased risk of comorbidities, including depression. This article reviews insomnia in CHF, cardiac medication side-effects related to sleep disturbances, and treatment options.

Brostrom A, Stromberg A, Dahlstrom U, Fridlund B (2004) Sleep difficulties, daytime sleepiness, and health-related quality of life in patients with chronic heart failure. J Cardiovasc Nurs 19(4):234–242PubMed

Katz DA, McHorney CA (1998) Clinical correlates of insomnia in patients with chronic illness. Arch Intern Med 158(10):1099–1107. doi:10.1001/archinte.158.10.1099 PubMedCrossRef

Silber MH (2005) Clinical practice. Chronic insomnia. N Engl J Med 353(8):803–810. doi:10.1056/NEJMcp043762 PubMedCrossRef

Diagnostic classification of sleep and arousal disorders (1979) 1st edn. Association of sleep disorders centers and the association for the psychophysiological study of sleep. Sleep 2(1):1–154

Drugs and insomnia (1984) NIH consensus development conference. National institutes of health consensus development conference summaries 4(10):1–9

Diagnostic and statistical manual of mental disorders (1994) 4th edn. Washington, DC

American Sleep Disorders Association DCSC (2005) International classifacation of sleep disorders, revised: diagnostic and coding manual. American Academy of Sleep Medicine, Westchester

NIH state of the science conference statement on manifestations and management of chronic insomnia in adults statement (2005) J Clin Sleep Med 1(4):412–421

Bixler EO, Kales A, Soldatos CR, Kales JD, Healey S (1979) Prevalence of sleep disorders in the Los Angeles metropolitan area. Am J Psychiatry 136(10):1257–1262PubMed

10.

Ford DE, Kamerow DB (1989) Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention? J Am Med Assoc 262(11):1479–1484. doi:10.1001/jama.262.11.1479 CrossRef

11.

Hohagen F (1996) Non-pharmacologic treatment of insomnia. Sleep 19:S50

12.

Mellinger GD, Balter M, Uhlenhuth EH (1985) Insomnia and its treatment. Prevalence and correlates. Arch Gen Psychiatry 42(3):225–232PubMed

13.

Morphy H, Dunn KM, Lewis M, Boardman HF, Croft PR (2007) Epidemiology of insomnia: a longitudinal study in a UK population. Sleep 30(3):274–280PubMed

14.

Foley D, Ancoli-Israel S, Britz P, Walsh J (2004) Sleep disturbances and chronic disease in older adults: results of the 2003 national sleep foundation sleep in America survey. J Psychosom Res 56(5):497–502. doi:10.1016/j.jpsychores.2004.02.010 PubMedCrossRef

15.

Foley DJ, Monjan AA, Brown SL, Simonsick EM, Wallace RB, Blazer DG (1995) Sleep complaints among elderly persons: an epidemiologic study of three communities. Sleep 18(6):425–432PubMed

16.

Buysse DJ, Reynolds CF 3rd, Kupfer DJ et al (1994) Clinical diagnoses in 216 insomnia patients using the international classification of sleep disorders (ICSD), DSM-IV and ICD-10 categories: a report from the APA/NIMH DSM-IV field trial. Sleep 17(7):630–637PubMed

17.

Sateia MJ, Doghramji K, Hauri PJ, Morin CM (2000) Evaluation of chronic insomnia. An American academy of sleep medicine review. Sleep 23(2):243–308PubMed

18.

Ohayon MM (2002) Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev 6(2):97–111. doi:10.1053/smrv.2002.0186 PubMedCrossRef

19.

Dodge R, Cline MG, Quan SF (1995) The natural history of insomnia and its relationship to respiratory symptoms. Arch Intern Med 155(16):1797–1800. doi:10.1001/archinte.155.16.1797 PubMedCrossRef

20.

Krakow B, Melendrez D, Ferreira E et al (2001) Prevalence of insomnia symptoms in patients with sleep-disordered breathing. Chest 120(6):1923–1929. doi:10.1378/chest.120.6.1923 PubMedCrossRef

21.

Principe-Rodriguez K, Strohl KP, Hadziefendic S, Pina IL (2005) Sleep symptoms and clinical markers of illness in patients with heart failure. Sleep Breath 9(3):127–133. doi:10.1007/s11325-005-0023-0 PubMedCrossRef

22.

Brostrom A, Johansson P (2005) Sleep disturbances in patients with chronic heart failure and their holistic consequences-what different care actions can be implemented? Eur J Cardiovas Nurs 4(3):183–197. doi:10.1016/j.ejcnurse.2005.04.005 CrossRef

23.

Pearson NJ, Johnson LL, Nahin RL (2006) Insomnia, trouble sleeping, and complementary and alternative medicine: analysis of the 2002 national health interview survey data. Arch Intern Med 166(16):1775–1782. doi:10.1001/archinte.166.16.1775 PubMedCrossRef

24.

Katz DA, McHorney CA (2002) The relationship between insomnia and health-related quality of life in patients with chronic illness. J Fam Pract 51(3):229–235PubMed

25.

Whitney CW, Enright PL, Newman AB, Bonekat W, Foley D, Quan SF (1998) Correlates of daytime sleepiness in 4578 elderly persons: the cardiovascular health study. Sleep 21(1):27–36PubMed

26.

Aldrich M (1994) Cardinal manifestations of sleep disorders. In: Kryger MR, Roth T, Dement WC (eds) Principles and practice of sleep medicine. WB Saunders, Philadelphia p 418

27.

Chokroverty S (1995) An approach to a patient with sleep complaints. In: Chokroverty S, (ed) Sleep disorders medicine: basic science. Butterworth-Heinemann, Boston p 181

28.

Erickson VS, Westlake CA, Dracup KA, Woo MA, Hage A (2003) Sleep disturbance symptoms in patients with heart failure. AACN Clin Issues 14(4):477–487. doi:10.1097/00044067-200311000-00009 PubMedCrossRef

29.

Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14(6):540–545PubMed

30.

Johns MW (1993) Daytime sleepiness, snoring, and obstructive sleep apnea. The Epworth sleepiness scale. Chest 103(1):30–36. doi:10.1378/chest.103.1.30 PubMedCrossRef

31.

Johns MW (1994) Sleepiness in different situations measured by the Epworth sleepiness scale. Sleep 17(8):703–710PubMed

32.

Carskadon MA, Dement WC, Mitler MM, Roth T, Westbrook PR, Keenan S (1986) Guidelines for the multiple sleep latency test (MSLT): a standard measure of sleepiness. Sleep 9(4):519–524PubMed

33.

Arzt M, Young T, Finn L et al (2006) Sleepiness and sleep in patients with both systolic heart failure and obstructive sleep apnea. Arch Intern Med 166(16):1716–1722. doi:10.1001/archinte.166.16.1716 PubMedCrossRef

34.

Foley DJ, Monjan A, Simonsick EM, Wallace RB, Blazer DG (1999) Incidence and remission of insomnia among elderly adults: an epidemiologic study of 6, 800 persons over three years. Sleep 22(Suppl 2):S366–S372PubMed

35.

Jessup M, Banner N, Brozena S et al (2006) Optimal pharmacologic and non-pharmacologic management of cardiac transplant candidates: approaches to be considered prior to transplant evaluation: International society for heart and lung Transplantation guidelines for the care of cardiac transplant candidates—2006. J Heart Lung Transplant 25(9):1003–1023. doi:10.1016/j.healun.2006.06.007 PubMedCrossRef

36.

Tamura A, Kawano Y, Naono S, Kotoku M, Kadota J (2007) Relationship between beta-blocker treatment and the severity of central sleep apnea in chronic heart failure. Chest 131(1):130–135. doi:10.1378/chest.06-0919 PubMedCrossRef

37.

Scheer FA, Stone PH, Shea SA (2007) Decreased sleep in heart failure: are medications to blame? Arch Intern Med 167(10):1098–1099. doi:10.10.1001/archinte.167.10.1098-b author reply 9–100PubMedCrossRef

38.

Bohlender JM, Waal-Manning HJ, Simpson FO (1990) A questionnaire survey of symptoms in a hypertension clinic. N Z Med J 103(901):533–536PubMed

39.

Kostis JB, Rosen RC, Wilson AC (1994) Central nervous system effects of HMG CoA reductase inhibitors: lovastatin and pravastatin on sleep and cognitive performance in patients with hypercholesterolemia. J Clin Pharmacol 34(10):989–996PubMed

40.

Stoschitzky K, Sakotnik A, Lercher P et al (1999) Influence of beta-blockers on melatonin release. Eur J Clin Pharmacol 55(2):111–115. doi:10.1007/s002280050604 PubMedCrossRef

41.

Stoschitzky K, Koshucharova G, Zweiker R et al (2001) Differing beta-blocking effects of carvedilol and metoprolol. Eur J Heart Fail 3(3):343–349. doi:10.1016/S1388-9842(01)00126-X PubMedCrossRef

42.

Monti JM, Jantos H, Monti D (2001) Evidence of melatonin involvement in pindolol-induced suppression of REM sleep. J Neural Transm 108(1):1–9. doi:10.1007/s007020170092 PubMedCrossRef

43.

Carpizo R, Martinez A, Mediavilla D, Gonzalez M, Abad A, Sanchez-Barcelo EJ (2006) Smith-Magenis syndrome: a case report of improved sleep after treatment with beta1-adrenergic antagonists and melatonin. J Pediatr 149(3):409–411. doi:10.1016/j.jpeds.2006.04.055 PubMedCrossRef

44.

Stoschitzky K, Stoschitzky G, Brussee H, Bonelli C, Dobnig H (2006) Comparing beta-blocking effects of bisoprolol, carvedilol and nebivolol. Cardiology 106(4):199–206. doi:10.1159/000093060 PubMedCrossRef

45.

Boriani G, Biffi M, Strocchi E, Branzi A (2001) Nightmares and sleep disturbances with simvastatin and metoprolol. Ann Pharmacother 35(10):1292. doi:10.1345/aph.10366 PubMedCrossRef

46.

Maebara C, Ohtani H, Sugahara H, Mine K, Kubo C, Sawada Y (2002) Nightmares and panic disorder associated with carvedilol overdose. Ann Pharmacother 36(11):1736–1740. doi:10.1345/aph.1A476 PubMedCrossRef

47.

Connolly JP, Silke B, McGavock H, Wilson-Davies K (1998) The use of angiotensin converting enzyme inhibitors in general practice—appropriate or inappropriate? Pharmacoepidemiol Drug Saf 7(5):331–337. doi :10.1002/(SICI)1099-1557(199809/10)7:5<331::AID-PDS365>3.0.CO;2-BPubMedCrossRef

48.

Heckman GA, Misiaszek B, Merali F et al (2006) Association between psychotropic drug use and heart failure therapy in elderly long-term care residents. J Am Geriatr Soc 54(12):1973–1975. doi:10.1111/j.1532-5415.2006.00995.x PubMedCrossRef

49.

Kantola I, Terent A, Honkanen T, Jarvelainen V, Ekman K, Kataja M (1996) Efficacy and safety of spirapril, a new ace-inhibitor, in elderly hypertensive patients. Eur J Clin Pharmacol 50(3):155–159. doi:10.1007/s002280050085 PubMedCrossRef

50.

Sica DA, Brath L (2006) Angiotensin-converting enzyme inhibition-emerging pulmonary issues relating to cough. Congest Heart Fail 12(4):223–226. doi:10.1111/j.1527-5299.2006.05746.x PubMedCrossRef

51.

Samizo K, Kawabe E, Hinotsu S et al (2002) Comparison of losartan with ACE inhibitors and dihydropyridine calcium channel antagonists: a pilot study of prescription-event monitoring in Japan. Drug Saf 25(11):811–821. doi:10.2165/00002018-200225110-00005 PubMedCrossRef

52.

Ancoli-Israel S (2006) The impact and prevalence of chronic insomnia and other sleep disturbances associated with chronic illness. Am J Manag Care 12(Suppl 8):S221–S229PubMed

53.

Skotzko CE (2007) Symptom perception in CHF: (why mind matters) Heart Fail Rev

54.

Adams KF Jr, Fonarow GC, Emerman CL et al (2005) Characteristics and outcomes of patients hospitalized for heart failure in the United States: rationale, design, and preliminary observations from the first 100,000 cases in the acute decompensated heart failure national registry (ADHERE). Am Heart J 149(2):209–216. doi:10.1016/j.ahj.2004.08.005 PubMedCrossRef

55.

Morin AK, Jarvis CI, Lynch AM (2007) Therapeutic options for sleep-maintenance and sleep-onset insomnia. Pharmacotherapy 27(1):89–110. doi:10.1592/phco.27.1.89 PubMedCrossRef

56.

Patel IH, Soni PP, Fukuda EK, Smith DF, Leier CV, Boudoulas H (1990) The pharmacokinetics of midazolam in patients with congestive heart failure. Br J Clin Pharmacol 29(5):565–569PubMed

57.

Charney DSMS, Harris RA (2006) Hypnotics and sedatives. In: Brunton LL, Lazo JS, Parker KL (eds) Goodman and Gilman’s the pharmacological basis of therapeutics. McGraw-Hill, Inc, New York, NY, pp 401–427

58.

Greenblatt DJ, Harmatz JS, von Moltke LL, Wright CE, Shader RI (2004) Age and gender effects on the pharmacokinetics and pharmacodynamics of triazolam, a cytochrome P450 3A substrate. Clin Pharmacol Ther 76(5):467–479. doi:10.1016/j.clpt.2004.07.009 PubMedCrossRef

59.

Wang JS, DeVane CL (2003) Pharmacokinetics and drug interactions of the sedative hypnotics. Psychopharmacol Bull 37(1):10–29PubMed

60.

Hindmarch I, Legangneux E, Stanley N, Emegbo S, Dawson J (2006) A double-blind, placebo-controlled investigation of the residual psychomotor and cognitive effects of zolpidem-MR in healthy elderly volunteers. Br J Clin Pharmacol 62(5):538–545. doi:10.1111/j.1365-2125.2006.02705.x PubMedCrossRef

61.

Ancoli-Israel S, Walsh JK, Mangano RM, Fujimori M (1999) Zaleplon, a novel nonbenzodiazepine hypnotic, effectively treats insomnia in elderly patients without causing rebound effects. Prim Care Companion J Clin Psychiatry 1(4):114–120PubMedCrossRef

62.

Krystal AD, Walsh JK, Laska E et al (2003) Sustained efficacy of eszopiclone over 6 months of nightly treatment: results of a randomized, double-blind, placebo-controlled study in adults with chronic insomnia. Sleep 26(7):793–799PubMed

63.

Roth T, Walsh JK, Krystal A, Wessel T, Roehrs TA (2005) An evaluation of the efficacy and safety of eszopiclone over 12 months in patients with chronic primary insomnia. Sleep Med 6(6):487–495. doi:10.1016/j.sleep. 2005.06.004 PubMedCrossRef

64.

McCall WV, Erman M, Krystal AD et al (2006) A polysomnography study of eszopiclone in elderly patients with insomnia. Curr Med Res Opin 22(9):1633–1642. doi:10.1185/030079906X112741 PubMedCrossRef

65.

Scharf M, Erman M, Rosenberg R et al (2005) A 2-week efficacy and safety study of eszopiclone in elderly patients with primary insomnia. Sleep 28(6):720–727PubMed

66.

Glass J, Lanctot KL, Herrmann N, Sproule BA, Busto UE (2005) Sedative hypnotics in older people with insomnia: meta-analysis of risks and benefits. BMJ 331(7526):1169. doi:10.1136/bmj.38623.768588.47 PubMedCrossRef

67.

Borja NL, Daniel KL (2006) Ramelteon for the treatment of insomnia. Clin Ther 28(10):1540–1555. doi:10.1016/j.clinthera.2006.10.016 PubMedCrossRef

68.

Mini LJ, Wang-Weigand S, Zhang J (2007) Self-reported efficacy and tolerability of ramelteon 8 mg in older adults experiencing severe sleep-onset difficulty. Am J Geriatr Pharmacother 5(3):177–184. doi:10.1016/j.amjopharm.2007.09.004 PubMedCrossRef

69.

Mendelson WB (2005) A review of the evidence for the efficacy and safety of trazodone in insomnia. J Clin Psychiatry 66(4):469–476PubMedCrossRef

70.

Lemoine P, Nir T, Laudon M, Zisapel N (2007) Prolonged-release melatonin improves sleep quality and morning alertness in insomnia patients aged 55 years and older and has no withdrawal effects. J Sleep Res 16(4):372–380. doi:10.1111/j.1365-2869.2007.00613.x PubMedCrossRef

71.

Morin CM, Culbert JP, Schwartz SM (1994) Nonpharmacological interventions for insomnia: a meta-analysis of treatment efficacy. Am J Psychiatry 151(8):1172–1180PubMed

72.

Sivertsen B, Omvik S, Pallesen S et al (2006) Cognitive behavioral therapy vs zopiclone for treatment of chronic primary insomnia in older adults: a randomized controlled trial. J Am Med Assoc 295(24):2851–2858. doi:10.1001/jama.295.24.2851 CrossRef

73.

Morin CM, Colecchi C, Stone J, Sood R, Brink D (1999) Behavioral and pharmacological therapies for late-life insomnia: a randomized controlled trial. J Am Med Assoc 281(11):991–999. doi:10.1001/jama.281.11.991 CrossRef

Title: Insomnia and chronic heart failure
Authors: Don Hayes Jr
Michael I. Anstead
Julia Ho
Barbara A. Phillips
Publication date: 01-09-2009
Publisher: Springer US
Published in: Heart Failure Reviews / Issue 3/2009
Print ISSN: 1382-4147
Electronic ISSN: 1573-7322
DOI: https://doi.org/10.1007/s10741-008-9102-1

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