Background 

Insomnia is a global problem and an important risk factor for patients living with cardiovascular disease (CVD), causing poor well-being and worsening disease prognosis. Yet, there is a lack of effective intervention strategies targeting sleep problems. To deliver patient-centered interventions and achieve good quality of sleep for this group, the own experiences of patients with CVD need to be understood.

Objective 

The aim of this study was to describe experiences that influence the sleep situation and management of sleep problems among patients with CVD and insomnia.

Method 

A qualitative descriptive design with critical incident technique methodology was used. Twenty patients (13 men and 7 women; mean age, 73 years; range, 47–83 years) with single or multiple verified CVD diagnoses and insomnia were included.

Results 

Four underlying categories of sleep disruptors were identified: cognitive, social, physical, and behavioral. Participants experienced distress from the heart condition at night, physically and cognitively, with high levels of concern about its consequences for themselves and their families. Participants' sleep management preferences and responses included cognitive, behavioral, and pharmacological management strategies. Participants preferred their own nonpharmacological insomnia management over professional advice.

Conclusion 

Patients with CVD and insomnia experienced both physical and cognitive distress from their heart condition and chose to adopt nonpharmacological insomnia management. Tailored professional support is needed to change precipitating behavioral factors to be able to treat insomnia, improve sleep, reduce symptom burden, and enhance quality of life.

中文翻译：

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影响心血管疾病和失眠患者睡眠的事件的经验和管理。

背景 

失眠是一个全球性问题，也是心血管疾病(CVD)患者的重要危险因素，导致健康状况不佳和疾病预后恶化。然而，缺乏针对睡眠问题的有效干预策略。为了为这一群体提供以患者为中心的干预措施并获得良好的睡眠质量，需要了解 CVD 患者的自身经历。

目标 

本研究的目的是描述影响 CVD 和失眠患者睡眠状况和睡眠问题管理的经历。

方法 

使用了具有关键事件技术方法的定性描述设计。20 名患者（13 名男性和 7 名女性；平均年龄为 73 岁；范围为 47-83 岁）具有单个或多个经证实的 CVD 诊断和失眠症。

结果 

确定了四种潜在的睡眠干扰因素：认知、社交、身体和行为。参与者在夜间经历了身体和认知方面的心脏病困扰，并高度关注其对自己和家人的后果。参与者的睡眠管理偏好和反应包括认知、行为和药物管理策略。与专业建议相比，参与者更喜欢他们自己的非药物失眠管理。

结论 

患有心血管疾病和失眠的患者因心脏病而经历了身体和认知方面的痛苦，并选择采用非药物失眠管理。需要量身定制的专业支持来改变诱发行为因素，从而能够治疗失眠、改善睡眠、减轻症状负担并提高生活质量。