Subjective Sleep Quality in Patients With Bradyarrhythmia and Its Changes After Cardiac Pacemaker Implantation

Patients with bradyarrhythmia requiring pacemaker implantation often report disrupted sleep, which could be related to bradyarrhythmia, apprehension of having heart disease and undiagnosed sleep disorders, resulting in impaired quality of life (QOL). We aimed to assess the prevalence of poor subjective sleep quality in patients with bradyarrhythmia requiring pacemaker implantation and its effect on sleep quality.

Patients undergoing permanent pacemaker implantation for bradyarrhythmia were evaluated for subjective sleep quality and health-related QOL using the Pittsburgh Sleep Quality Index (PSQI) and Short Form-8 (SF-8) before and after pacemaker implantation. Poor subjective sleep quality was defined as PSQI score ≥6. Of 89 enrolled patients, 54 (60.7%) reported poor subjective sleep quality. A greater PSQI score indicative of poor sleep quality was likely to be observed in patients who had greater left ventricular ejection fraction and were treated with calcium-channel blockers, as well as in patients with more frequent sleep disturbance-related complaints/symptoms. After pacemaker implantation, the PSQI score improved significantly (from a median score of 6.0 to 5.0; P=0.015) proportional to an improvement in the mental component summary score.

Poor subjective sleep quality is common among patients with bradyarrhythmia, contributing to impaired QOL. Pacemaker implantation may have a favorable effect on subjective sleep quality, and QOL for such patients.