Abstract 112: Exploring Sleep Disturbance Among Patients With Symptomatic Peripheral Artery Disease: Results From the Project Voice Pilot Study

Abstract

Background: Sleep disturbance is an important determinant of both mental and physical health-related quality of life (QOL). Associations between sleep disturbance and subclinical cardiovascular disease have been described but little is known about it among patients with symptomatic PAD. We studied sleep disturbance in symptomatic PAD patients using a wearable device for 30 days. Methods: Patients with claudication confirmed by ABI<0.9 were recruited to participate. Participants received walking exercise instruction, a wearable device to track walking activity and sleep, and an iPad with access to a PAD-specific digital health platform with educational materials and patient surveys. Participants set personal walking goals, received weekly telephone follow up, and completed quality of life instruments [Walking Impairment Questionnaire (WIQ) and VascuQol-6] at baseline and post-completion. Poisson regression was used to examine associations between number of nights with sleep interruption, patient characteristics and survey responses. Results: Twenty participants enrolled and completed the study; 35% were female; 30% were African American. Mean age was 69±9 years; mean ABI was 0.69±0.14. Over a mean study period of 34±6 days, sleep data were recorded an average of 28±6 days and walking activity on 12±10 days. Mean nights of interrupted sleep was 1.3±1.8; 8 participants (40%) had sleep interruption at least one night. No associations were observed between daily walking activity or VascuQol-6 scores and sleep disturbance. Increases in sleep disturbance were associated with higher (i.e., more severe) WIQ distance (P=0.02) and stair (P=0.03) scores at baseline, and WIQ distance (P=0.03), speed (P=0.002) and overall (P=0.009) scores at study completion. Conclusions: These observations suggest that sleep disturbance impacts walking, disability and QOL among people with symptomatic PAD. Further investigation is warranted to characterize sleep disturbance among patients with both claudication and critical limb ischemia, evaluate associations with disease severity, and explore utility as a treatment outcome.