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In chronic heart failure, cognitive impairment and sleeplessness are frequently encountered. This study explored the outcomes of cognitive behavioural therapy for insomnia (CBT-I). Also, the researchers assessed how well demographic, clinical, symptom, and functional traits anticipated cognition in individuals with chronic heart failure and insomnia who took part in a randomized trial of CBT-I.
In adults with chronic heart failure and insomnia, the use of CBT-I appears to be associated with improvement in cognition.
In chronic heart failure, cognitive impairment and sleeplessness are frequently encountered. This study explored the outcomes of cognitive behavioural therapy for insomnia (CBT-I). Also, the researchers assessed how well demographic, clinical, symptom, and functional traits anticipated cognition in individuals with chronic heart failure and insomnia who took part in a randomized trial of CBT-I.
A total of 175 heart failure-affected people (43% women) were randomly allocated to group-based CBT-I or an attention control (heart failure self-management education). Results were tracked for a full year. Sleepiness (Epworth Sleepiness Scale), wrist actigraphy (rest activity rhythms, sleep characteristics), six-minute walk distance, psychomotor vigilance test (PVT) and self-reported cognitive ability (Patient-Reported Outcomes Measurement Information System [PROMIS] Cognitive Abilities Scale), demographic and clinical characteristics, sleep apnea history, exhaustion, pain, insomnia (Insomnia Severity Index), and EuroQoL Quality of Life were all assessed.
Rest activity rhythms were calculated utilizing cosinor analysis, and the impacts of predictors over a year were examined using general linear models and general estimating equations.
In the CBT-I group, a noteworthy group-time effect was noted on self-reported cognitive function and a rise in the percentage of individuals having < 3 PVT lapses. Six-minute walk distance, reduced drowsiness, and better rest activity rhythms were predictive of a composite outcome of cognition (self-reported cognition, PVT lapses) after controlling for group-time effects and baseline cognition.
In chronic heart failure and insomnia-affected adults, CBT-I may improve cognition. The extent to which CBT-I enhances many cognition-related domains will need to be confirmed in a future fully powered trial.
Journal of Clinical Sleep Medicine
Sleep-related predictors of cognition among adults with chronic insomnia and heart failure enrolled in a randomized controlled trial of cognitive behavioral therapy for insomnia
Nancy S. Redeker et al.
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