title: Sleep and health-related quality of life in heart failure.
abstract: This study characterized sleep in heart failure (HF) and determined associations with quality of life. Forty stable HF patients and 34 healthy volunteers were studied in a clinical research unit. HF patients had more central apneas per hour (17.6 vs 5.4; P< or =.01) and obstructive apneas per hour (21.7 vs 8.5; P< or =.05), spent more time in stage 1 sleep (54 vs 35 min; P< or =.05), and had more respiratory awakenings following apneic events (27.2 vs 4.2; P< or =.01). More HF patients were depressed (55% vs 27.2%; P< or =.01) and had worse fatigue (P< or =.05). In multiple regression analysis, physical functioning quality of life was predicted by reduced left ventricular ejection fraction (P< or =.05), shorter distance on a 6-minute walk test (P< or =.05), greater fatigue (P< or =.01), and more apneas ( P< or =.05) (model R(2)=.672; P< or =.001). Emotional functioning quality of life was predicted by greater fatigue (P< or =.01) (model adjusted R(2)=.732; P<.001). Findings provide evidence that in addition to functional status and ongoing fatigue, poorer quality of life in HF is independently related to the severity of sleep-disordered breathing.
authors.affiliation: Department of Psychiatry, University of California San Diego, La Jolla, CA, USA. pmills@ucsd.edu
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Mills
authors.forename: Joel E
authors.initials: JE
authors.lastname: Dimsdale
authors.forename: Loki
authors.initials: L
authors.lastname: Natarajan
authors.forename: Michael G
authors.initials: MG
authors.lastname: Ziegler
authors.forename: Alan
authors.initials: A
authors.lastname: Maisel
authors.forename: Barry H
authors.initials: BH
authors.lastname: Greenberg
mesh_terms: D000704:Analysis of Variance; D003863:Depression; D004569:Electroencephalography; D005260:Female; D006305:Health Status Indicators; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017286:Polysomnography; D011594:Psychometrics; D011788:Quality of Life; D012044:Regression Analysis; D012890:Sleep; D012893:Sleep Wake Disorders / Q000209:etiology*; D013318:Stroke Volume; D011795:Surveys and Questionnaires; D016277:Ventricular Function, Left