From a contextual, holistic perspective on health, it is important to identify the patient's needs, symptoms and intentional or unintentional self-care management strategies regarding sleep and lifestyle. To promote a positive health outcome it is essential to identify sleeplessness behaviour and perceived self-efficacy for self-care in sleep.

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This study evaluated self-reported subjective health and effects of sleep loss according to perceived interfering cognitive anxiety related to falling asleep in patients with and without insufficient sleep and gender differences in these aspects 5 years after coronary artery bypass graft and transluminal coronary angioplasty. A total of 145 patients, five years after intervention, responded to a mailed questionnaire. Nearly 60% had severe combined sleep disturbances; 35.9% of these had complained of insufficient sleep and 15% also perceived difficulty falling asleep related to cognitive anxiety. Measurable gender differences were small. A theoretical framework is presented which can increase understanding among nurses, patients and their relatives concerning the quality and quantity of sleep and sleep loss related to quality of life. These results suggest that there are significant relationships between sleep quality, resilience to stress and coping strategy in patients with a chronic disease, indicating the need for more individualised supportive nursing care.

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