Sleep disordered breathing, daytime symptoms, and functional performance in stable heart failure.

STUDY

OBJECTIVES

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.

DESIGN

Cross-sectional, observational study.

SETTING

Structured heart failure disease management programs.

PARTICIPANTS

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).

INTERVENTIONS: N/A.

MEASUREMENTS AND

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.