title: Sleep disturbance, symptoms, psychological distress, and health-related quality of life in pulmonary arterial hypertension.
abstract: BACKGROUND
  Pulmonary arterial hypertension (PAH) is a devastating disease characterized by elevated pulmonary pressures that lead to right heart failure and premature mortality. Patients experience multiple symptoms including dyspnea, fatigue and chest pain, but little is known about sleep disturbance, PAH symptoms, psychological distress and health-related quality of life (HRQOL) in PAH.
  
  
  OBJECTIVE
  The purpose of this study was to describe the occurrence of sleep disturbance and compare PAH symptoms, psychological distress, and HRQOL across severity of sleep disturbance.
  
  
  METHODS
  One hundred and ninety-one participants completed a socio-demographic and clinical data form, PAH Symptom Severity Scale, Profile of Mood States (POMS) short form and the Medical Outcomes Short Form-36 (SF-36). Descriptive statistics were used to describe sleep disturbances; analysis of variance models were used to quantify differences in PAH symptoms, psychological distress and HRQOL by sleep disturbance groups.
  
  
  RESULTS
  The majority of participants (n=162, 85%) were women with a mean age of 53 years. Sixty-five (34%) reported no sleep disturbance; 54 (28%) mild sleep disturbance; 41 (22%) moderate sleep disturbance; and 31 (16%) severe sleep disturbance. Those reporting higher sleep disturbance severity reported worse PAH symptoms, psychological distress, and HRQOL.
  
  
  CONCLUSIONS
  Sleep disturbance is a significant finding in PAH. Increasing levels of sleep disturbance are associated with worse PAH symptoms, psychological states, and health-related quality of life. Interventions that decrease sleep disturbances may improve symptoms and HRQOL.
authors.affiliation: University of Pennsylvania, USA matura@nursing.upenn.edu.
authors.forename: Lea Ann
authors.initials: LA
authors.lastname: Matura
authors.affiliation: University of Massachusetts, USA.
authors.forename: Annette
authors.initials: A
authors.lastname: McDonough
authors.affiliation: University of Pennsylvania, USA.
authors.forename: Alexandra L
authors.initials: AL
authors.lastname: Hanlon
authors.affiliation: Munn Center for Nursing Research, Institute for Patient Care, USA.
authors.forename: Diane L
authors.initials: DL
authors.lastname: Carroll
authors.affiliation: University of Pennsylvania, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Riegel
mesh_terms: D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011788:Quality of Life; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology*
keywords: Sleep; health-related quality of life; psychological states; sleep disorders