Correlations Between Sleep Quality And Cognitive Function In Patients Of Chronic Heart Failure

Background:Chronic heart failure is the end stage of varied cardiovascular diseases and the chief causes of death.The CHF patients with sleep disorders were 30%~70%.With the development of rapid population aging,cognitive impairment come a severe social problem.CHF patients run four times the risk of developing cognitive impairment than does the general population,with an estimated 25%~75% of CHF patients exhibiting cognitive deficits.Poor cognitive function often lead to dementia,which with CHF seriously affect the prognosis of patients and impose heavy socio-economic burdens. Research shows that poor sleep is associated with cognitive impairment in elder people,but under the influence of disease especially CHF, whether reported sleep disorders are associated with poor cognitive functioning and which sleep quality dimension is needed are not clear.Under the background of gradually increasing incidence in CHF,it is deserved to be urgently researched in order to attain aims that take attention to the value of sleep disorders and cognitive impairment in patients of CHF,perform early prevention,early detection,early treatment,ensure the continuity of nursing care,and improve the quality of life. Objectives:To describe sleep quality and cognitive function.To investigate the incidence of sleep disorders and cognitive impairment.To explore the relationships between sleep quality and cognitive function,and to provide theoretical support for clinical workers to improve it. Methods:Pittsburgh sleep quality index(PSQI) and Montreal Cognitive Assessment(Mo CA) were used to assess sleep status and cognitive function of 155 patients in CHF who were randomly selected from the tertiary hospital of Changchun during June 2014 to July 2015.This study simultaneously collects relevant variables from general information to analyze influence of sleep status and cognitive function.Using Epidata3.1 to establish data,SPSS20.0 application software for statistical analysis. The statistical methods included chi-square test, chi-square decomposition, independent sample t-test, Pearson correlation and multi-linear regression models. Results:1. Sleep problems were common within the sample of patients in CHF,as the sample has an average PSQI of 7.50±2.25,82 patients occur sleep disorders and the prevalence rate was 52.91%.According to the severity was sleep efficiency,sleep latency and daytime dysfunction in order.The average of the Mo CA score was 24.37±2.22,64 patients and 41.29% of patients from cognitive impairment with the specific cognitive functions-abstraction, attention, language, visuospatial/executive function, delayed recall, naming and orientation.2. Compared with demographic data and sleep disorders,the difference was significant between sleep disorders and different age groups, marriage and levels of education.Among the patients,different gender experience poor sleep problems(p<0.05).According to the results of relevant data and sleep disturbance,poor sleepers had significantly higher NYHA classification and course of diseases(p<0.01).3.Result of demographic data and cognitive impairment show that the difference between cognitive impairment and different age groups and marriage were statistically significant(p<0.01).Among the patients,the different gender and economic conditions experience poor sleep,the data was statistical significant(p<0.05).There were significant differences among the incidence of cognitive dysfunction and different levels of NYHA classification and course of diseases(p<0.01).4.By analyzing the results of Pearson correlation,the scores of PSQI and all domains of Mo CA were negatively related; the scores of PSQI were statistically correlated to visuospatial/executive function,naming,abstraction, orientation and scores of Mo CA(p<0.01);the scores of PSQI were statistically correlated with the score of Mo CA in attention, language and delayed recall(p<0.05).5.The multi-linear regression analysis showed that sleep duration,sleep latency and daytime dysfunction were the main factors of cognitive function which was negatively correlated with three dimensions,and the influence from high to low was sleep duration,daytime dysfunction and sleep latency. Conclusion:1.Because of higher rates of sleep disorders which was damaged severely in sleep efficiency,sleep latency and daytime dysfunction,it was closely related to age, gender, marital status, education, NYHA grades and course of the disease.2.Because of higher rates of cognitive impairment,the patients in CHF which is elderly,widowed,long course and NYHA III or IV should be prevented.The seriously injured domains were abstraction, attention and language.3.The worser the sleep quality,the severer cognitive function.4.Sleep quality is a determinant of cognitive function in CHF patients.