Abstract
Heart failure (HF) is well-known for its deleterious effects on functional performance and quality of life, and this problem has been persistent despite advances in pharmacological and other treatments. Sleep disturbance, including decreased quantity, fragmentation, and poor self-reported quality, and sleep disordered breathing (Cheyne-Stokes breathing/central sleep apnea and obstructive sleep apnea) are common in HF patients and there is beginning evidence that both sleep and SDB contribute to functional performance. However, the bio-behavioral attributes of sleep in HF patients, the contribution of sleep disturbance and SDB to functional performance, and the behavioral pathways through which this may occur have not yet been explained. Therefore, the purpose of this study is to explicate the nature of sleep disturbance and its contributions to functional performance in a well-defined group of stable HF patients. The specific aims are to:
- Characterize the physiologic, behavioral, and subjective attributes of sleep disturbance in HF patients;
- Evaluate the contributions of sleep disturbance and SDB (SDB-CSA and OSA) to functional performance of HF patients
- Examine the relationships among nocturnal symptoms, sleep disturbance and SDB; and the contributions of sleep disturbance and SDB in
- Mood disturbance
- Excessive daytime sleepiness
- Fatigue in HF patients
- Evaluate the extent to which fatigue, excessive daytime sleepiness, and mood disturbance mediate the contributions of sleep disturbance to functional performance in HF patients
- Evaluate the influence of age and gender on the relationships between sleep disturbance and functional performance in patients with HF
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