Grateful to have spoken to Kristin Flanary ⁦@LGlaucomflecken⁩ about “co-survivors”: the often-unheard partners who support patients & who are invaluable therapeutic allies but have their own value & stories to share #NationalCaregiverAwarenessMonth

“Melatonin—> 90% ⬆️ risk for heart failure!? “ 🤯 Not so fast. This is an ABSTRACT using TriNetX data- would be super careful in saying patients are “matched” - this is an ASSOCIATION that is wrought with residual confounding. Patients with insomnia may be at higher risk - by

Highlight of #AHA25 🚨Meeting @LGlaucomflecken in person. We were both co-authors on the @AHAScience scientific statement, "Patient-Centered Adult #Cardiovascular Care". We talked about co-survivorship. Missing @DGlaucomflecken 🚨 https://t.co/1sLZcDXlT9

We need billing codes that facilitate support for caregivers by someone within the care team. #AHA25

CARE, an evidence-based framework: 4 themes for caregiver interventions: - Caregiver-centered - Active engagement - Reflection and reinforcement - Education But we need much more research! (N.B. Hint, hint, pretty please!) #AHA25

Gaps/future directions: - What intervention components would result in better outcomes? - Paucity of intervention descriptions - Limited number of targeted interventions for caregivers own health - Currently more dyadic interventions vs caregiver-only interventions #AHA25

Meta-analysis of review articles on caregiving for heart failure patients: 3 common components of caregiver healthy outcomes: - Education (skill building) - Support (referrals, supportive calls, etc.) - Guidance (verbal or written instructions) #AHA25

❤️ Interventions to Support Caregivers of Patients with Heart Disease to Promote Healthy Behaviors and Cardiovascular Health 🎤 Miyeon Jung There’s a need for interventions targeted for caregivers. #AHA25

Caregiver preparedness can improve both patient and caregiver depression and quality of life. AHA Statement: - Make it systematic to identify caregiver s within your practice - Educate them on care needs they will need to provide - Know when they are at their limit #AHA25

Caregiving strain is associated with all-cause mortality of caregivers. This is perhaps due to health behavior changes. #AHA25

Context of caregiving matters: Dyadic relationship Caregiving intensity Social support Financial resources Home environment #AHA25

Colorful lines are when caregiver steps in. #AHA25

There are caregiving burdens and benefits. Consequences of time spent caregiving: missed work (especially important for women threw workplace), financial stress, emotional stress #AHA25

Levels of resilience: Individual, family, community, society Theory of Dyadic (or, often, family) Illness Management Think about family strengths when considering caregiving measures #AHA25

❤️ Caregiver Burden, Health-Related Quality of Life, and Psychological Well-Being 🎤 Martha Abshire Saylor Resilience requires a multilevel approach. Think of caregiver burden as a sign that the resilience structures of families are being overwhelmed. #AHA25

Treatment: - 1st line: CBT for Insomnia (but shortage of CBT-I providers) - Sleep hygiene - Light therapy - Exercise - Address caregiving distress - Consider respite care #AHA25

3-P Model of Insomnia: - Predisposing factors - Precipitating factors - Perpetuating factors Caregiving is a potent precipitating factor. Insomnia may remain even after caregiving ends. #AHA25

Caregiving: - 2.4-3.5 hours/week less! - 76% report poor sleep quality - Women more likely to do the caregiving, and have higher risk for sleep issues most impacted by caregiving #AHA25

Validated sleep health measure: RU-SATED. Less than 75% of US adults get at least 7 hrs of sleep. #AHA25

Sleep dimensions: duration, timing, quality, regularity. Circadian rhythms impact all aspects of our lives.l, including CVD (per recent AHA statement), #AHA25