Connecting the Dots: Heart Failure and Insomnia
DOI:
https://doi.org/10.12775/JEHS.2024.62.013Keywords
cardiovascular diesease, dyssomnia, heart failure, life quality, public health, sleepAbstract
Introduction and aim. This study investigates the relationship between heart failure (HF) and insomnia, focusing on this two-way association’s clinical significance, epidemiology, and management.
Material and methods. Literature available in November 2023 was searched using Pubmed, Medline, Google Scholar, and Europe PMC with keywords associated with Heart Failure, Insomnia, and related pharmaceuticals. 69 articles were included.
Analysis of the literature. Insomnia is associated with higher mortality and a potential risk of sudden cardiac death, particularly in individuals with HF. Treatment is challenging and side effects can worsen the symptoms of HF. The use of benzodiazepines in HF patients raises concerns about cardiovascular risks, prompting the exploration of other medications like nonbenzodiazepines, antidepressants with sedative effects, and histamine receptor antagonists. On the other hand, HF is also a condition that affects sleep quality. Drugs including ACE-I, beta-blockers, MRA, and SGLT2i are essential for its treatment. Some of them may have an impact on the intensity of insomnia.
Conclusion. Considering the impact of insomnia medications on heart failure outcomes and vice versa is necessary. It is important to consider all aspects when treating these two conditions simultaneously.
References
Gharzeddine R, McCarthy MM, Yu G, Dickson VV. Insomnia and Insomnia Symptoms in Persons With Heart Failure: An Integrative Review. J Cardiovasc Nurs. Jul-Aug 01 2021;36(4):374-384. doi:10.1097/JCN.0000000000000719
Morin CM, Vezina-Im LA, Ivers H, et al. Prevalent, incident, and persistent insomnia in a population-based cohort tested before (2018) and during the first-wave of COVID-19 pandemic (2020). Sleep. Jan 11 2022;45(1)doi:10.1093/sleep/zsab258
Sateia MJ. International classification of sleep disorders-third edition: highlights and modifications. Chest. Nov 2014;146(5):1387-1394. doi:10.1378/chest.14-0970
Leger D, Morin CM, Uchiyama M, Hakimi Z, Cure S, Walsh JK. Chronic insomnia, quality-of-life, and utility scores: comparison with good sleepers in a cross-sectional international survey. Sleep Med. Jan 2012;13(1):43-51. doi:10.1016/j.sleep.2011.03.020
Vgontzas AN, Liao D, Pejovic S, et al. Insomnia with short sleep duration and mortality: the Penn State cohort. Sleep. Sep 2010;33(9):1159-64. doi:10.1093/sleep/33.9.1159
Sulej L, Momot K, Zarębiński M, Wojciechowska M. Reperfusion arrhythmias – underestimated cause of sudden cardiac death? Medical Hypotheses. 2023.
Li X, Zhou T, Ma H, et al. Healthy Sleep Patterns and Risk of Incident Arrhythmias. J Am Coll Cardiol. Sep 21 2021;78(12):1197-1207. doi:10.1016/j.jacc.2021.07.023
Lip GY, Heinzel FR, Gaita F, et al. European Heart Rhythm Association/Heart Failure Association joint consensus document on arrhythmias in heart failure, endorsed by the Heart Rhythm Society and the Asia Pacific Heart Rhythm Society. Europace. Jan 2016;18(1):12-36. doi:10.1093/europace/euv191
Mahmood A, Ray M, Dobalian A, Ward KD, Ahn S. Insomnia symptoms and incident heart failure: a population-based cohort study. Eur Heart J. Oct 21 2021;42(40):4169-4176. doi:10.1093/eurheartj/ehab500
Tsao CW, Aday AW, Almarzooq ZI, et al. Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association. Circulation. Feb 22 2022;145(8):e153-e639. doi:10.1161/CIR.0000000000001052
Lee KS, Lennie TA, Heo S, Song EK, Moser DK. Prognostic Importance of Sleep Quality in Patients With Heart Failure. American Journal of Critical Care. 2016;25(6):516-525. doi:10.4037/ajcc2016219
Okumura T, Sawamura A, Murohara T. Palliative and end-of-life care for heart failure patients in an aging society. Korean J Intern Med. Nov 2018;33(6):1039-1049. doi:10.3904/kjim.2018.106
Brewster GS, Riegel B, Gehrman PR. Insomnia in the Older Adult. Sleep Med Clin. Jun 2022;17(2):233-239. doi:10.1016/j.jsmc.2022.03.004
Skotzko CE. Symptom perception in CHF: (why mind matters). Heart Fail Rev. Mar 2009;14(1):29-34. doi:10.1007/s10741-007-9059-5
Savarese G, Becher PM, Lund LH, Seferovic P, Rosano GMC, Coats AJS. Global burden of heart failure: a comprehensive and updated review of epidemiology. Cardiovasc Res. Jan 18 2023;118(17):3272-3287. doi:10.1093/cvr/cvac013
Troxel WM, Buysse DJ, Matthews KA, et al. Sleep symptoms predict the development of the metabolic syndrome. Sleep. Dec 2010;33(12):1633-40. doi:10.1093/sleep/33.12.1633
Laugsand LE, Vatten LJ, Platou C, Janszky I. Insomnia and the risk of acute myocardial infarction: a population study. Circulation. Nov 8 2011;124(19):2073-81. doi:10.1161/CIRCULATIONAHA.111.025858
Momot K, Krauz K, Czarzasta K, Zarębiński M, Puchalska L, Wojciechowska M. Evaluation of Nitrosative/Oxidative Stress and Inflammation in Heart Failure with Preserved and Reduced Ejection Fraction. International Journal of Molecular Sciences. 2023;24(21):15944.
Ng ML, Ang X, Yap KY, et al. Novel Oxidative Stress Biomarkers with Risk Prognosis Values in Heart Failure. Biomedicines. Mar 15 2023;11(3)doi:10.3390/biomedicines11030917
Paraskevaidis I, Farmakis D, Papingiotis G, Tsougos E. Inflammation and Heart Failure: Searching for the Enemy-Reaching the Entelechy. J Cardiovasc Dev Dis. Jan 4 2023;10(1)doi:10.3390/jcdd10010019
Semenova NV, Madaeva IM, Brichagina AS, Kolesnikov SI, Kolesnikova LI. 8-Hydroxy-2'-Deoxyguanosine as an Oxidative Stress Marker in Insomnia. Bull Exp Biol Med. Jul 2021;171(3):384-387. doi:10.1007/s10517-021-05233-0
Ballesio A. Where does inflammation in insomnia come from? and does it matter for comorbidity? Sleep. Oct 11 2023;46(10)doi:10.1093/sleep/zsad223
Zhang DY, Anderson AS. The sympathetic nervous system and heart failure. Cardiol Clin. Feb 2014;32(1):33-45, vii. doi:10.1016/j.ccl.2013.09.010
Mann DL. Mechanisms and models in heart failure: A combinatorial approach. Circulation. Aug 31 1999;100(9):999-1008. doi:10.1161/01.cir.100.9.999
Kemp CD, Conte JV. The pathophysiology of heart failure. Cardiovasc Pathol. Sep-Oct 2012;21(5):365-71. doi:10.1016/j.carpath.2011.11.007
Johnson FL. Pathophysiology and etiology of heart failure. Cardiol Clin. Feb 2014;32(1):9-19, vii. doi:10.1016/j.ccl.2013.09.015
Jorge-Samitier P, Fernandez-Rodrigo MT, Juarez-Vela R, Anton-Solanas I, Gea-Caballero V. Management of Hypnotics in Patients with Insomnia and Heart Failure during Hospitalization: A Systematic Review. Nurs Rep. May 21 2021;11(2):373-381. doi:10.3390/nursrep11020036
Sateia MJ, Buysse DJ, Krystal AD, Neubauer DN, Heald JL. Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med. Feb 15 2017;13(2):307-349. doi:10.5664/jcsm.6470
Redeker NS, Jeon S, Andrews L, Cline J, Jacoby D, Mohsenin V. Feasibility and Efficacy of a Self-Management Intervention for Insomnia in Stable Heart Failure. J Clin Sleep Med. Oct 15 2015;11(10):1109-19. doi:10.5664/jcsm.5082
Chuang C, Hsiao FC, Cheng YW, et al. Benzodiazepines in Patients with Heart Failure and Reduced Ejection Fraction. Acta Cardiol Sin. Sep 2022;38(5):573-583. doi:10.6515/ACS.202209_38(5).20220406A
Ribeirinho-Soares P, Madureira S, Elias C, et al. Benzodiazepine use and mortality in chronic heart failure. Pol Arch Intern Med. Oct 26 2023;133(10)doi:10.20452/pamw.16464
Ishak WW, Bagot K, Thomas S, et al. Quality of life in patients suffering from insomnia. Innov Clin Neurosci. Oct 2012;9(10):13-26.
Gatti RC, Burke PR, Otuyama LJ, Almeida DR, Tufik S, Poyares D. Effects of Zolpidem CR on Sleep and Nocturnal Ventilation in Patients with Heart Failure. Sleep. Aug 1 2016;39(8):1501-5. doi:10.5665/sleep.6006
Wichniak A, Wierzbicka AE, Jarema M. Treatment of insomnia - effect of trazodone and hypnotics on sleep. Psychiatr Pol. Aug 31 2021;55(4):743-755. Leczenie bezsennosci - wplyw trazodonu i lekow nasennych na sen. doi:10.12740/PP/125650
Jaffer KY, Chang T, Vanle B, et al. Trazodone for Insomnia: A Systematic Review. Innov Clin Neurosci. Jul-Aug 2017;14(7-8):24-34.
Fagiolini A, Gonzalez-Pinto A, Miskowiak KW, Morgado P, Young AH, Vieta E. Role of trazodone in treatment of major depressive disorder: an update. Ann Gen Psychiatry. Sep 2 2023;22(1):32. doi:10.1186/s12991-023-00465-y
De Crescenzo F, D'Alo GL, Ostinelli EG, et al. Comparative effects of pharmacological interventions for the acute and long-term management of insomnia disorder in adults: a systematic review and network meta-analysis. Lancet. Jul 16 2022;400(10347):170-184. doi:10.1016/S0140-6736(22)00878-9
Pina IL, Di Palo KE, Ventura HO. Psychopharmacology and Cardiovascular Disease. J Am Coll Cardiol. May 22 2018;71(20):2346-2359. doi:10.1016/j.jacc.2018.03.458
Giardina E-GV, Johnson LL, Vita J, Bigger Jr JT, Brem RF. Effect of imipramine and nortriptyline on left ventricular function and blood pressure in patients treated for arrhythmias. American heart journal. 1985;109(5):992-998.
Krishnan KR. Broken heart: depression in cardiovascular disease. Dialogues Clin Neurosci. Jun 2003;5(2):167-74. doi:10.31887/DCNS.2003.5.2/krkrishnan
Lasisi GT, Adebola AP, Ogah OS, Daniel FA. Prevalence of ventricular arrhythmias and heart rate variability pattern in chronic heart failure. Niger Postgrad Med J. Sep 2012;19(3):157-62.
Calvi A, Fischetti I, Verzicco I, et al. Antidepressant Drugs Effects on Blood Pressure. Front Cardiovasc Med. 2021;8:704281. doi:10.3389/fcvm.2021.704281
Gorelik O, Feldman L, Cohen N. Heart failure and orthostatic hypotension. Heart Fail Rev. Sep 2016;21(5):529-38. doi:10.1007/s10741-016-9541-z
Al-Majed A, Bakheit AH, Alharbi RM, Abdel Aziz HA. Mirtazapine. Profiles Drug Subst Excip Relat Methodol. 2018;43:209-254. doi:10.1016/bs.podrm.2018.01.002
Barreto JN, Cullen MW, Mara KC, et al. QT prolongation in patients with acute leukemia or high-risk myelodysplastic syndrome prescribed antifungal prophylaxis during chemotherapy-induced neutropenia. Leuk Lymphoma. Dec 2019;60(14):3512-3520. doi:10.1080/10428194.2019.1639165
Khawaja IS, Feinstein RE. Cardiovascular effects of selective serotonin reuptake inhibitors and other novel antidepressants. Heart Dis. Mar-Apr 2003;5(2):153-60. doi:10.1097/01.hdx.0000061695.97215.64
Song HR, Bahk WM, Woo YS, et al. Efficacy and Tolerability of Generic Mirtazapine (Mirtax) for Major Depressive Disorder: Multicenter, Open-label, Uncontrolled, Prospective Study. Clin Psychopharmacol Neurosci. Aug 31 2015;13(2):144-9. doi:10.9758/cpn.2015.13.2.144
Behlke LM, Lenze EJ, Carney RM. The Cardiovascular Effects of Newer Antidepressants in Older Adults and Those With or At High Risk for Cardiovascular Diseases. CNS Drugs. Nov 2020;34(11):1133-1147. doi:10.1007/s40263-020-00763-z
Huynh DA, Abbas M, Dabaja A. Diphenhydramine Toxicity. StatPearls. 2023.
Taglialatela M, Timmerman H, Annunziato L. Cardiotoxic potential and CNS effects of first-generation antihistamines. Trends Pharmacol Sci. Feb 2000;21(2):52-6. doi:10.1016/s0165-6147(99)01437-6
Nishino T, Wakai S, Aoki H, Inokuchi S. Cardiac arrest caused by diphenhydramine overdose. Acute Med Surg. Oct 2018;5(4):380-383. doi:10.1002/ams2.351
Eckes L, Tsokos M, Herre S, Gapert R, Hartwig S. Toxicological identification of diphenhydramine (DPH) in suicide. Forensic Sci Med Pathol. Jun 2013;9(2):145-53. doi:10.1007/s12024-012-9383-5
Jasinska-Piadlo A, Campbell P. Management of patients with heart failure and preserved ejection fraction. Heart. May 15 2023;109(11):874-883. doi:10.1136/heartjnl-2022-321097
Wagdy K, Nagy S. EMPEROR-Preserved: SGLT2 inhibitors breakthrough in the management of heart failure with preserved ejection fraction. Glob Cardiol Sci Pract. Oct 30 2021;2021(3):e202117. doi:10.21542/gcsp.2021.17
McDonagh TA, Metra M, Adamo M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. Sep 21 2021;42(36):3599-3726. doi:10.1093/eurheartj/ehab368
Lin WL, Chen YR, Lai CT, et al. Neural mechanism of angiotensin-converting enzyme inhibitors in improving heart rate variability and sleep disturbance after myocardial infarction. Sleep Med. Aug 2018;48:61-69. doi:10.1016/j.sleep.2018.04.007
Kolesnikova O, Zaprovalna O, Bondar T, Potapenko A. Influence of obesity on biological age in patients with arterial hypertension. Arterial Hypertension. 2023;27(2):88-98. doi:{}
Khandwalla RM, Grant D, Birkeland K, et al. The AWAKE-HF Study: Sacubitril/Valsartan Impact on Daily Physical Activity and Sleep in Heart Failure. Am J Cardiovasc Drugs. Mar 2021;21(2):241-254. doi:10.1007/s40256-020-00440-y
Jimenez JA, Greenberg BH, Mills PJ. Effects of Heart Failure and its Pharmacological Management on Sleep. Drug Discov Today Dis Models. Winter 2011;8(4):161-166. doi:10.1016/j.ddmod.2011.02.006
Samizo K, Kawabe E, Hinotsu S, et al. Comparison of losartan with ACE inhibitors and dihydropyridine calcium channel antagonists: a pilot study of prescription-event monitoring in Japan. Drug Saf. 2002;25(11):811-21. doi:10.2165/00002018-200225110-00005
Pratt-Ubunama MN, Nishizaka MK, Boedefeld RL, Cofield SS, Harding SM, Calhoun DA. Plasma aldosterone is related to severity of obstructive sleep apnea in subjects with resistant hypertension. Chest. Feb 2007;131(2):453-9. doi:10.1378/chest.06-1442
Fares A. Night-time exogenous melatonin administration may be a beneficial treatment for sleeping disorders in beta blocker patients. J Cardiovasc Dis Res. Jul 2011;2(3):153-5. doi:10.4103/0975-3583.85261
Pope E. Commentary:Beta-blockers and sleep problems. Pediatr Dermatol. Mar 2021;38(2):378-379. doi:10.1111/pde.14537
Gehrman PR, Anafi RC. Treatment of a patient with a circadian sleep-wake disorder using a combination of melatonin and metoprolol. J Clin Sleep Med. Oct 1 2021;17(10):2121-2124. doi:10.5664/jcsm.9410
Pandi-Perumal SR, Srinivasan V, Maestroni GJ, Cardinali DP, Poeggeler B, Hardeland R. Melatonin: Nature's most versatile biological signal? FEBS J. Jul 2006;273(13):2813-38. doi:10.1111/j.1742-4658.2006.05322.x
Brismar K, Mogensen L, Wetterberg L. Depressed melatonin secretion in patients with nightmares due to beta-adrenoceptor blocking drugs. Acta Med Scand. 1987;221(2):155-8. doi:10.1111/j.0954-6820.1987.tb01260.x
Kales A, Bixler EO, Vela-Bueno A, et al. Effects of nadolol on blood pressure, sleep efficiency, and sleep stages. Clin Pharmacol Ther. Jun 1988;43(6):655-62. doi:10.1038/clpt.1988.91
Sahin S, Haliloglu O, Polat Korkmaz O, et al. Does treatment with sodium-glucose co-transporter-2 inhibitors have an effect on sleep quality, quality of life, and anxiety levels in people with Type 2 diabetes mellitus? Turk J Med Sci. Dec 28 2020;51(2):735-742. doi:10.3906/sag-2008-37
Grunert SC, Venema A, LaFreniere J, et al. Patient-reported outcomes on empagliflozin treatment in glycogen storage disease type Ib: An international questionnaire study. JIMD Rep. May 2023;64(3):252-258. doi:10.1002/jmd2.12364
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