DOI

https://doi.org/10.25772/35NE-6P93

Author ORCID Identifier

0000-0001-6998-2688

Defense Date

2025

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Rehabilitation and Movement Science

First Advisor

Dr. Salvatore Carbone

Second Advisor

Dr. Rayan garten

Third Advisor

Dr. Danielle Kirkman

Fourth Advisor

Dr. Alexander R. Lucas

Abstract

Background: Short sleeping habits or poor sleep quality have been identified as one of the significant risk factors for heart failure with preserved ejection fraction (HFpEF). Behavioral sleep extension intervention in short sleepers has a positive health outcome. However, it is yet to be tested in patients with HFpEF who often suffer from poor sleep quality.

Objective: We assessed the feasibility of a personalized sleep extension intervention in patients with HFpEF who habitually sleep less < 7 hours/day, with sleep primarily measured by wrist actigraphy. Design We conducted a 2-week single-arm open-label feasibility study in patients with HFpEF with a 1-week run-in phase with a behavioral sleep extension intervention (sleep coaching + sleep hygiene training) to improve sleep efficiency.

Result: Sleep extension intervention significantly increased bedtime (+0.26 hours, p= 0.021), sleep time (+0.6 hours, p= 0.001), sleep efficiency (+5.7%, p=0.004), reduction in WASO (-17.7 minutes, p= 0.002), movement index (-5.3%, p=0.006), and SFI (-8.1, p=0.009). In addition, 6 minutes’ walk distance increased by 20.14 ±17.7 (p=0.009) meters, reduced systolic blood pressure by 5.8±6.1 mmHg (p=0.036), improved social limitation score (+8.3, p=0.043), overall summary score (+2.5, p=0.011), clinical summary score (+ 3.8, p=0.05) and increased total UFA intake (+7.7 gm, p=0.017), omega-6 fatty acid (+9.6 gm, p= 0.022).

Conclusion: We showed the feasibility of behavioral intervention to extend sleep in patients with HFpEF. Sleep extension positively impacted functional capacity, blood pressure, diet quality, and QoL. This result demands an adequately powered randomized clinical trial with a proper comparison group and a longer-term intervention.

Rights

© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

8-6-2025

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