Abstract 4136745: How do sleep quality and heart failure symptoms impact functional status among patients with heart failure?

Abstract

Background: Patients with heart failure (HF) frequently experience poor sleep quality and multiple HF symptoms, both of which are linked to diminished functional status. Poor sleep quality can manifest as prolonged latency, short duration, low efficiency, or difficulty staying asleep. HF symptoms encompass different dimensions: presence, frequency, severity, and distress of HF symptoms. Different dimensions of sleep quality and HF symptoms may uniquely influence functional status, necessitating tailored interventions, yet how individual dimensions of sleep quality and HF symptoms impact functional status remains unexplored. Research Question: how do individual dimensions of sleep quality and HF symptoms impact functional status in patients with HF? Methods: We studied 197 adults with HF (male: 66%, age: 62±11 yrs). The Pittsburgh Sleep Quality Index was used to assess seven dimensions of sleep quality: subjective sleep quality, latency, duration, efficiency, sleep disturbances, use of sleeping medications, and daytime dysfunction over the last month. Four dimensions (i.e., presence, frequency, severity, distress) of 7 HF symptoms (e.g., shortness of breath, fatigue, swelling) were assessed using the Symptom Status Questionnaire-HF. Functional status was measured using the Duke Activity Status Index. Correlations and two multiple linear regression models (1 st model: 7 dimensions of sleep quality on functional status, and 2 nd model: 4 dimensions of HF symptoms on functional status) were conducted for data analysis. Results: Worse subjective sleep quality, longer latency, more sleep disturbances, use of sleeping medications, and higher levels of daytime dysfunction were correlated with poor functional status. All four dimensions of HF symptoms were negatively correlated with functional status. In the 1 st multiple linear regression model, more sleep disturbances (B=-3.91, p =.006) and higher daytime dysfunction (B=-5.70, p <.001) were predictive of poor functional status (model R 2 =0.23, p <.001). In the 2 nd multiple linear regression model, only higher frequency of HF symptoms (B=-.70, p =.022) predicted poor functional status (model R 2 =0.34, p <.001). Conclusion: Increased sleep disturbances, daytime dysfunction, and frequency of HF symptoms were associated with poorer functional status in patients with HF. These findings underscore the importance of developing tailored interventions to address individual sleep problems and HF symptoms to improve functional status.