Dataset Information

Sleep fragmentation and incidence of congestive heart failure: the Sleep Heart Health Study.

ABSTRACT:

Study objectives

Sleep fragmentation (SF) has been reported to be associated with cardiovascular risk. The aim of this study was to explore the relationship between SF and congestive heart failure (CHF).

Methods

A total of 4,887 participants (2,256 males and 2,631 females; mean age of 63.6 ± 11.0 years) from the Sleep Heart Health Study were included in this study. Incident CHF was defined as the first occurrence of CHF between baseline in-home polysomnography (PSG) and the end of follow-up. Objective assessments for SF, including sleep fragmentation index (SFI), arousal index (ArI), sleep efficiency (SE), and wake after sleep onset (WASO), were determined based on in-home PSG records. Multivariate Cox regression analysis was used to investigate the relationship between SF and incident CHF.

Results

During an average of 10 years of follow-up, 543 participants with CHF (11.1%) were observed. Individuals with CHF had a significantly higher SFI, total ArI, and WASO and a lower SE than controls. After multivariate Cox regression analysis, SE (odds ratio [OR], 0.967; 95% confidence interval [CI], 0.955-0.978; P < .001), WASO (OR, 1.009; 95% CI, 1.006-1.012; P < .001), SFI (OR, 1.046; 95% CI, 1.007-1.086; P = .021), and total ArI (OR, 1.018; 95% CI, 1.000-1.035; P = .044) were found to be associated with the incidence of CHF in participants without hypertension.

Conclusions

Objectively measured SF was associated with the incidence of CHF. The role of SFI, total ArI, SE, and WASO deserves further investigation.

Clinical trial registration

Registry: ClinicalTrials.gov; Name: Sleep Heart Health Study (SHHS) Data Coordinating Center (SHHS); URL: https://clinicaltrials.gov/ct2/show/NCT00005275; Identifier: NCT00005275.

Citation

Yan B, Wu Y, Fan X, Lu Q, Ma X, Bai L. Sleep fragmentation and incidence of congestive heart failure: the Sleep Heart Health Study. J Clin Sleep Med. 2021;17(8):1619-1625.

SUBMITTER: Yan B

PROVIDER: S-EPMC8656916 | biostudies-literature | 2021 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Sleep fragmentation and incidence of congestive heart failure: the Sleep Heart Health Study.

Yan Bin B Wu Yanhua Y Fan Xiaojuan X Lu Qun Q Ma Xiancang X Bai Ling L

Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine 20210801 8

<h4>Study objectives</h4>Sleep fragmentation (SF) has been reported to be associated with cardiovascular risk. The aim of this study was to explore the relationship between SF and congestive heart failure (CHF).<h4>Methods</h4>A total of 4,887 participants (2,256 males and 2,631 females; mean age of 63.6 ± 11.0 years) from the Sleep Heart Health Study were included in this study. Incident CHF was defined as the first occurrence of CHF between baseline in-home polysomnography (PSG) and the end of ...[more]

PMID: 33779541

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Project description:ObjectiveHeart failure (HF) continues to be a leading cause of hospital admissions, particularly in underserved patients. We hypothesised that providing individualised self-management support to patients and feedback on use of evidence-based HF therapies (EBT) to physicians could lead to improvements in care and decrease hospitalisations. To assess the feasibility of conducting a larger trial testing the efficacy of this dual-level intervention, we conducted the Congestive Heart failure Adherence Redesign Trial Pilot (CHART-P), a proof-of-concept, quasi-experimental, feasibility pilot study.SettingA large tertiary care medical centre in Chicago.ParticipantsLow-income patients (<US$30,000/year) hospitalised for exacerbation of systolic HF (ejection fraction ≤50%) and their physicians. Twenty physicians and 33 patients were enrolled, of whom 23 patients completed the study.InterventionsPhysicians received HF guidelines and periodic individualised feedback on their adherence to EBT. Patients received HF education, support and self-management training for diet and medication adherence by a trained nurse through 11 interactive sessions over a 4-month period. Evaluations were conducted pre-enrolment and 1 month postintervention completion.Outcome measuresFeasibility was assessed by the ability to deliver intervention to patients and physicians. Exploratory outcomes included changes in medication and sodium intake for patients and adherence to EBT for physicians.ResultsEighty-seven per cent and 82% of patients received >80% of interventions at 1 month and by study completion, respectively. Median sodium intake declined (3.5 vs 2.0 g; p<0.01). There was no statistically significant change in medication adherence based on electronic pill cap monitoring or the Morisky Medication Adherence Scale (MMAS); however, there was a trend towards improved adherence based on MMAS. All physicians received timely intervention.ConclusionsThis pilot study demonstrated that the protocol was feasible. It provided important insights about the need for intervention and the difficulties in treating patients with a variety of psychosocial problems that undercut their effective care.

Dataset Information

Sleep fragmentation and incidence of congestive heart failure: the Sleep Heart Health Study.

Study objectives

Methods

Results

Conclusions

Clinical trial registration

Citation

Publications

Sleep fragmentation and incidence of congestive heart failure: the Sleep Heart Health Study.

Similar Datasets

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