title: Poor sleep quality is associated with exercise limitation in precapillary pulmonary hypertension.
abstract: BACKGROUND
  Patients with precapillary pulmonary hypertension (PH) have been reported to suffer from poor sleep quality, however, if this is related to physical exercise performance has not yet been thoroughly investigated.
  
  
  METHODS
  Clinically stable out-patients with idiopathic pulmonary arterial hypertension (IPAH, n = 52) and chronic thromboembolic PH (CTEPH, n = 64) in NYHA classes II and III were prospectively enrolled. 54 healthy volunteers matched for anthropometric variables served as a control group. The Pittsburgh Sleep Quality Index (PSQI) was used to rate subjective sleep quality. In the PH patients, six-minute walk tests (6MWT) were performed to assess exercise capacity.
  
  
  RESULTS
  Poor sleep quality (i.e. a PSQI score > 5) occurred more frequently in PH (IPAH: n = 25 [48.1%], CTEPH: n = 39 [60.9%], controls: n = 10 [18.5%]; p < 0.01 when compared to controls). In addition, poor vs. good sleepers had significantly higher average NYHA class (IPAH: 2.6 ± 0.1 vs. 2.3 ± 0.1, CTEPH: 2.8 ± 0.1 vs. 2.3 ± 0.2; p < 0.01) and shorter 6MWT distances (IPAH: 338 ± 23 vs. 441 ± 29 m, CTEPH: 355 ± 15 vs. 413 ± 26 m; p < 0.05).
  
  
  CONCLUSIONS
  Self-reported poor sleep quality is more common in PH than in healthy controls. Furthermore, it is related to reduced physical exercise capacity.
authors.affiliation: Department of Sleep Medicine, University of Giessen Lung Center, Klinikstr. 33, 35392, Giessen, Germany. Henning.Tiede@innere.med.uni-giessen.de.
authors.forename: Henning
authors.initials: H
authors.lastname: Tiede
authors.affiliation: Department of Sleep Medicine, University of Giessen Lung Center, Klinikstr. 33, 35392, Giessen, Germany. janetrorzyczka@arcor.de.
authors.forename: Janet
authors.initials: J
authors.lastname: Rorzyczka
authors.affiliation: Department of Sleep Medicine, University of Giessen Lung Center, Klinikstr. 33, 35392, Giessen, Germany. Rio.Dumitrascu@innere.med.uni-giessen.de.
authors.forename: Rio
authors.initials: R
authors.lastname: Dumitrascu
authors.affiliation: Department of Sleep Medicine, University of Giessen Lung Center, Klinikstr. 33, 35392, Giessen, Germany. Michael.Belly@innere.med.uni-giessen.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Belly
authors.affiliation: Department of Pneumology, Asklepios Lung Center, Munich-Gauting, Germany. f.reichenberger@asklepios.com.
authors.forename: Frank
authors.initials: F
authors.lastname: Reichenberger
authors.affiliation: Department of Sleep Medicine, University of Giessen Lung Center, Klinikstr. 33, 35392, Giessen, Germany. h.ghofrani@kerckhoff-klinik.de.
authors.forename: Hossein Ardeschir
authors.initials: HA
authors.lastname: Ghofrani
authors.affiliation: Department of Sleep Medicine, University of Giessen Lung Center, Klinikstr. 33, 35392, Giessen, Germany. Werner.Seeger@innere.med.uni-giessen.de.
authors.forename: Werner
authors.initials: W
authors.lastname: Seeger
authors.affiliation: Department of Sleep Medicine, University of Giessen Lung Center, Klinikstr. 33, 35392, Giessen, Germany. heitmann_j@yahoo.de.
authors.forename: Jörg
authors.initials: J
authors.lastname: Heitmann
authors.affiliation: Department of Sleep Medicine, University of Giessen Lung Center, Klinikstr. 33, 35392, Giessen, Germany. Richard.Schulz@innere.med.uni-giessen.de.
authors.forename: Richard
authors.initials: R
authors.lastname: Schulz
mesh_terms: D016022:Case-Control Studies; D002908:Chronic Disease; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology*; D065627:Familial Primary Pulmonary Hypertension / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000453:epidemiology / Q000503:physiopathology*; D012890:Sleep / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000503:physiopathology*