Sleep timing irregularity after hospitalization for acutely decompensated heart failure may be associated with a higher short-term risk of adverse events, according to a secondary analysis.

In a cohort of 32 patients with heart failure (HF) (mean age, 62.6 years; 44% female; mean body mass index, 32.8 kg/m²), those with moderately irregular sleep schedules had more than twice the 6-month risk of all-cause emergency visits, rehospitalization, or death compared with those with regular schedules (adjusted HR, 3.7; 95% CI, 1.2-12.2; P = .03).

Participants completed 7-day sleep diaries, which were used to calculate the Sleep Regularity Index (SRI). Patients were classified as regular (SRI greater than 87%) or moderately irregular (SRI 87% or less). Over follow-up, 21 patients experienced a clinical event, including 13 of 16 in the irregular group and 8 of 16 in the regular group. Median time to event was shorter among irregular sleepers compared to regular sleepers (26 vs 35 days). These patients also showed higher comorbidity scores (4.9 vs 3.4; P = .02) and lower SRI values (79% vs 92%; P < .01), while sleep duration and onset times were similar across groups.

The researchers cautioned that the study was limited by its small sample size, which reduced the ability to account for potential confounders such as sleep apnea treatment. In addition, the cohort was predominantly non-Hispanic White, which may limit generalizability. They noted that larger and more diverse studies are needed to confirm whether targeting sleep regularity could help improve outcomes in patients with HF.

Source: JACC: Advances