Management of Hypnotics in Patients with Insomnia and Heart Failure during Hospitalization: A Systematic Review.

Autor:	Jorge-Samitier P; Hospital Clínico Lozano Blesa, Avenida San Juan Bosco, 15, 50009 Zaragoza, Spain.; Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain., Fernández-Rodrigo MT; Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain., Juárez-Vela R; Faculty of Medicine, University of Salamanca, Avenida Alfonso X El Sabio SN, 37008 Salamanca, Spain., Antón-Solanas I; Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain.; Research Group GENIAPA (GIIS094), Institute of Research of Aragon, Avenida San Juan Bosco, 13, 50009 Zaragoza, Spain., Gea-Caballero V; Nursing School La Fe, Adscript Center of the University of Valencia, Research Group GREIACC, Health Research Institute La Fe, 46026 Valencia, Spain.
Jazyk:	angličtina
Zdroj:	Nursing reports (Pavia, Italy) [Nurs Rep] 2021 May 21; Vol. 11 (2), pp. 373-381. Date of Electronic Publication: 2021 May 21.
DOI:	10.3390/nursrep11020036
Abstrakt:	Background: Heart failure is a chronic, progressive syndrome of signs and symptoms, which has been associated to a range of comorbidities including insomnia. Acute decompensation of heart failure frequently leads to hospital admission. During hospital admission, long-term pharmacological treatments such as hypnotics can be modified or stopped. Aim: To synthesize the scientific evidence available about the effect of withdrawing hypnotic drugs during hospital admission in patients with decompensated heart failure and insomnia. Method: A systematic review of the literature following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines was carried out in the following scientific databases: PubMed, Scopus, Dialnet and Cochrane. Inclusion Criteria: studies including a population of adults with heart failure and sleep disorders in treatment with hypnotics and admitted to hospital, studies written in English or Spanish and published until June 2020. Exclusion Criteria: studies involving children, patients admitted to intensive care and patients diagnosed with sleep apnea. Results: We identified a total of 265 documents; only nine papers met the selection criteria. The most frequently used drugs for the treatment of insomnia in patients with heart failure were benzodiazepines and benzodiazepine agonists; their secondary effects can alter perceived quality of life and increase the risk of adverse effects. Withdrawal of these drugs during hospital admission could increase the risk of delirium. Future research in this area should evaluate the management of hypnotics during hospital admission in patients with decompensated heart failure. In addition, safe and efficient non-pharmacological alternatives for the treatment of insomnia in this population should be tested and implemented.
Databáze:	MEDLINE
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