Sleep disordered breathing, daytime symptoms, and functional performance in stable heart failure.
OBJECTIVE
To evaluate characteristics of sleep disordered breathing (SDB); clinical and demographic correlates of SDB; and the extent to which SDB explains functional performance and symptoms in stable heart failure patients receiving care in structured HF disease management programs.


METHODS
Cross-sectional, observational study.


METHODS
Structured heart failure disease management programs.


METHODS
170 stable chronic heart failure patients (mean age = 60.3 +/- 16.8 years; n = 60 [35%] female; n = 50 [29%] African American; left ventricular ejection fraction mean = 32 +/- 14.6).


METHODS
N/A.


RESULTS
Full polysomnography was obtained for one night on participants in their homes. Participants completed the 6-minute walk, 3 days of actigraphy, MOS-SF 36, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Multi-Dimensional Assessment of Fatigue Scale, and the Centers for the Epidemiological Studies of Depression Scale. Fifty-one percent had significant SDB; Sixteen (9%) of the total sample had central sleep apnea. Severe SDB was associated with a 4-fold increase in the likelihood of poor self-reported physical function (OR = 4.15, 95%CI = 1.19-14.57) and CSA was associated with low levels of daytime mobility (OR = 4.09, 95%CI = 1.23-13.62) after controlling for clinical and demographic variables. There were no statistically significant relationships between SDB and daytime symptoms or self-reported sleep, despite poorer objective sleep quality in patients with SDB.


CONCLUSIONS
Severe SDB is associated with poor physical function in patients with stable HF but not with daytime symptoms or self-reported sleep, despite poorer objective sleep quality in patients with SDB.
Redeker
Nancy S
NS
Yale University School of Nursing, New Haven, CT, USA. Nancy.redeker@yale.edu
Muench
Ulrike
U
Zucker
Mark J
MJ
Walsleben
Joyce
J
Gilbert
Michelle
M
Freudenberger
Ronald
R
Chen
Ming
M
Campbell
Della
D
Blank
Lenore
L
Berkowitz
Robert
R
Adams
Laura
L
Rapoport
David M
DM
D056044:Actigraphy / Q000379:methods / Q000706:statistics & numerical data; D000203:Activities of Daily Living; D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology; D005080:Exercise Test / Q000379:methods / Q000706:statistics & numerical data*; D005221:Fatigue / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009511:New England / Q000453:epidemiology; D016017:Odds Ratio; D017286:Polysomnography / Q000379:methods / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012650:Self Disclosure; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000453:epidemiology* / Q000523:psychology
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