Wake After Sleep Onset

No associations were found between any sleep parameter and handgrip strength or dynamic balance as measured by the Timed Up and Go Test. The mechanism linking wake after sleep onset to gait speed in heart failure may involve underlying insomnia, excessive daytime sleepiness, and sleep-disordered breathing, though these were not directly measured. Greater wake after sleep onset was significantly associated with slower gait speed, lower ADL independence, worse frailty, and reduced quality-of-life scores in older heart failure patients. Cognitive-behavioural therapy for insomnia in heart failure patients has been shown to produce sustained improvements in Six-Minute Walk Test distance, insomnia severity, and daytime sleepiness.