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

Abstract

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.

Sleep and stress in times of the COVID‐19 pandemic: The role of personal resources

“…Previous research on self-care has mainly been conducted in patient samples (with reference to specific diseases) or caregivers (Casida et al, 2018;Shapiro et al, 2007). Nevertheless, especially in periods of crisis self-care behaviors should be investigated in the whole population as they might be useful for everyone.…”

“…Further, sleep has mostly been considered as a predictor for self-care behavior (e.g. Casida et al, 2018). A study by Di Benedetto et al (2019) found healthy self-care behaviors went along with good sleep quality, suggesting that healthy self-care behavior might also promote good sleep.…”

Self-care in Adults With a Retro-auricular Left Ventricular Assist Device: An Interpretive Description

“…This is relevant, because short sleep duration and poor sleep are associated with coronary heart disease, metabolic disorders (Lao et al, 2018), and depressive symptoms (Lippman et al, 2017). Poor sleep quality has been reported in people with abdominal LVADs, when often results in worse performances in the activities of daily living (Casida et al, 2018). However, participants in this study reported an overall good sleep quality; as previously shown in people with the abdominal version of the device, this could be due to decreasing symptom burden and to improvements in patients’ adaptation to the LVAD (Casida et al, 2018).…”