Sleep and health-related quality of life in heart failure

This study characterized sleep in heart failure (HF) and determined associations with quality of life. Forty stable HF patients and 34 healthy volunteers were studied in a clinical research unit. HF patients had more central apneas per hour (17.6 vs 5.4; P< or =.01) and obstructive apneas per hour (21.7 vs 8.5; P< or =.05), spent more time in stage 1 sleep (54 vs 35 min; P< or =.05), and had more respiratory awakenings following apneic events (27.2 vs 4.2; P< or =.01). More HF patients were depressed (55% vs 27.2%; P< or =.01) and had worse fatigue (P< or =.05). In multiple regression analysis, physical functioning quality of life was predicted by reduced left ventricular ejection fraction (P< or =.05), shorter distance on a 6-minute walk test (P< or =.05), greater fatigue (P< or =.01), and more apneas ( P< or =.05) (model R(2)=.672; P< or =.001). Emotional functioning quality of life was predicted by greater fatigue (P< or =.01) (model adjusted R(2)=.732; P<.001). Findings provide evidence that in addition to functional status and ongoing fatigue, poorer quality of life in HF is independently related to the severity of sleep-disordered breathing.