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. Author manuscript; available in PMC: 2010 Dec 1.
Published in final edited form as: Eur J Cardiovasc Nurs. 2009 Aug 13;8(5):337–344. doi: 10.1016/j.ejcnurse.2009.06.003

Figure 1.

Figure 1

Conceptual Model of How Poor Sleep Influences Self-Care and Outcomes in Persons with Heart Failure

Two known effects of chronic heart failure are disturbed sleep and impaired cognition. Many other factors accentuate the sleep problems experienced by the majority of this patient population. These factors further impair cognitive functioning and can cause excessive daytime sleepiness. Early evidence suggests that heart failure patients with impaired cognition find self-care difficult. Poor self-care is associated with an increase in symptoms and impaired functioning, which may predispose patients to poor long-term outcomes and independently contribute to impaired cognition. Depression, common in persons with heart failure, independently contributes to many of the concepts in this model.