Abstract
Abstract Introduction Few recent, population-level datasets have explored the relationship between congestive heart failure (CHF) and sleep difficulties. Methods The 2017 - March 2020 data from the National Health and Nutrition Examination Survey (NHANES) were used. Sleep difficulties were self-reported as difficulties “falling asleep, staying asleep, or sleeping too much” within the previous two weeks, categorized as “never,” “less than half the days,” “more than half the days,” and “nearly every day.” Sleep duration was self-reported and categorized as normal (6.5-8.5h), short (<6.5h), and long (>8.5h). A modified STOP-BANG score was created based on NHANES measures of snoring, daytime tiredness, snorting/gasping during sleep, hypertension, body mass index, age, and gender (no measure of neck circumference). Covariates included sex, age, race/ethnicity, education, and relationship status. Analyses were unweighted, with weighted results forthcoming. Results Those who reported sleep difficulties more than half the days (OR: 1.78, [1.20,2.65], p=0.004) and nearly every day (OR: 2.76, [2.01,3.78], p<0.001) were more likely to also report a history of CHF, relative to those without sleep difficulties. After adjusting for covariates these relationships were maintained for those who reported sleep difficulties more than half the days (OR: 1.71, [1.14,2.58], p=0.010) and nearly every day (OR: 2.45, [1.76,3.41] p<0.001). When adding sleep duration category as a covariate (normal, short, or long sleep), those diagnosed with CHF were more likely to have sleep problems nearly every day (OR: 2.21, [1.38,3.25], p<0.001). Those diagnosed with CHF are also likely to have a high risk for OSA (OR: 1.67, [1.39,1.95], p<0.001). Conclusion Poor sleep quality is associated with history of CHF, independent of sleep duration. CHF is also associated with population-level sleep apnea risk. Screening for sleep disorders (insomnia and/or sleep apnea) in CHF patients may improve outcomes. Support (If Any)
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