Contributions of Comorbid Diabetes to Sleep Characteristics, Daytime Symptoms, and Physical Function Among Patients With Stable Heart Failure.
Contributions of Comorbid Diabetes to Sleep Characteristics, Daytime Symptoms, and Physical Function Among Patients With Stable Heart Failure.
复制标题
合并症糖尿病对稳定心力衰竭患者的睡眠特征，白天症状和身体机能的贡献。
DOI：
10.1097/jcn.0000000000000183
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发表时间：
2015-09
期刊：
影响因子：
--
通讯作者：
Redeker NS
中科院分区：
文献类型：
--
作者：
Fritschi C;Redeker NS
Diabetes (DM) and heart failure (HF) are often comorbid. Sleep disturbances, poor physical functioning, and high levels of daytime symptoms are prevalent and contribute to poor quality of life in both populations. However, little is known about the independent and additive effects of comorbid DM on sleep, physical function, and daytime symptoms among patients with HF. To investigate the extent to which comorbid DM confers independent and additive effects on sleep disturbance, physical functioning, and symptoms among patients with stable HF. This secondary analysis was conducted on a sample of 173 stable Class II-IV HF patients. Self-report and polysomnography were used to measure sleep quality, objective sleep characteristics, and sleep disordered breathing. Physical function measures included wrist actigraphy, the six minute walk test, and the SF-36 Physical Component Summary Score. Fatigue, sleepiness, and depression were also measured. Univariate analyses and hierarchical regression models were computed. The sample included 173 (n = 119/68% HF and n = 54/32% HF plus DM) patients (age 60.4 ± 16.1 years). In analyses adjusted for age, gender, BMI, and NY Heart Association classification, HF patients with DM had longer sleep latency and spent a greater percentage of time awake after sleep onset (WASO %] than the HF patients who did not have DM (all p < .05). There were no statistically significant differences in respiratory disturbance index (RDI) or self-reported sleep quality. Sleep duration was low in both groups. Patients with DM had shorter 6MWT distance, lower ratio of daytime to nighttime activity, and lower general health and self-reported physical function. Hierarchical regression models revealed that age and DM were the only significant correlates of the sleep variables, while age, gender, NYHA class, and DM were all associated with 6MWT distance. Comorbid DM contributes independent and additive effects on sleep disturbances and poor physical functioning in patients with stable HF.
