Søvnløse netter og søvnige dager: en kvalitativ studie som undersøker opplevelsene til pasienter med kronisk hjertesvikt og pusteforstyrrelser under søvn.

Pusteforstyrrelser under søvn, som obstruktiv søvnapné (OSA) og sentral søvnapné (CSA), er en vanlig komorbid lidelse hos pasienter med kronisk hjertesvikt (CHF). Pasienter med OSA behandles ofte med CPAP, mens pasienter med CSA og CHF mangler et klart behandlingsalternativ. Forskere fra St. Olavs hospital, Høgskulen på Vestlandet, NTNU, Haukeland universitetssykehus, Jönköping universitet og Linköping universitet har i denne studien undersøkt hvordan pusteforstyrrelser under søvn oppleves av pasienter med CHF. Resultatene viste at pasientgruppen sov dårlig, og det ble brukt ulike selvhjelpsmetoder som er lite evidensbaserte. Studien konkluderer med at det er behov for nye og klare retningslinjer for behandling av sentral søvnapné hos pasienter med kronisk hjertesvikt, og som ikke behandles med CPAP.

Sleepless nights and sleepy days: a qualitative study exploring the experiences of patients with chronic heart failure and newly verified sleep-disordered breathing.

Marianne Gullvåg, Kari Hanne Gjeilo, Nina Fålun, Tone N. Norekvål, Rune Mo, Anders Broström

Publisert i Nordic College of Caring Sciences

BACKGROUND: Sleep-disordered breathing, including obstructive sleep apnoea and central sleep apnoea, is a common disorder among patients with chronic heart failure. Obstructive sleep apnoea is often treated with continuous positive airway pressure, but central sleep apnoea lacks a clear treatment option. Knowledge of how sleep-disordered breathing is experienced (e.g. difficulties and care needs) and handled (e.g. self-care actions) by the patients is limited, but needed, to provide patient-centred care.
AIM: To explore how newly verified sleep-disordered breathing is experienced by patients with chronic heart failure.
METHODS: Data were collected through semi-structured interviews and analysed with qualitative content analysis. Seventeen participants (14 men, three women), mean age 60 years (range 41-80) diagnosed with chronic heart failure and objectively verified sleep-disordered breathing (nine obstructive, seven central and one mixed) were strategically selected from heart failure outpatient clinics at two Norwegian university hospitals.
RESULTS: Patients with chronic heart failure and newly verified sleep-disordered breathing (SDB) described experiences of poor sleep that had consequences for their daily life and their partners. Different self-care strategies were revealed, but they were based on 'common sense' and were not evidence-based. The awareness of having SDB was varied; for some, it gave an explanation to their trouble while others were surprised by the finding.
CONCLUSION: Patients with chronic heart failure and sleep-disordered breathing experienced reduced sleep quality, influencing their daily life. Possible underlying causes of disrupted sleep, such as sleep-disordered breathing, should be identified to establish proper patient-centred treatment strategies. There is a need for new strategies to approach patients with chronic heart failure (i.e. those with central sleep apnoea) who are not subject to continuous positive airway pressure treatment for their sleep-disordered breathing.