title: Sleep disordered breathing, daytime symptoms, and functional performance in stable heart failure.
abstract: 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.
authors.affiliation: Yale University School of Nursing, New Haven, CT, USA. Nancy.redeker@yale.edu
authors.forename: Nancy S
authors.initials: NS
authors.lastname: Redeker
authors.forename: Ulrike
authors.initials: U
authors.lastname: Muench
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Zucker
authors.forename: Joyce
authors.initials: J
authors.lastname: Walsleben
authors.forename: Michelle
authors.initials: M
authors.lastname: Gilbert
authors.forename: Ronald
authors.initials: R
authors.lastname: Freudenberger
authors.forename: Ming
authors.initials: M
authors.lastname: Chen
authors.forename: Della
authors.initials: D
authors.lastname: Campbell
authors.forename: Lenore
authors.initials: L
authors.lastname: Blank
authors.forename: Robert
authors.initials: R
authors.lastname: Berkowitz
authors.forename: Laura
authors.initials: L
authors.lastname: Adams
authors.forename: David M
authors.initials: DM
authors.lastname: Rapoport
mesh_terms: 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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