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Association between sleep‐disordered breathing, sleep–wake pattern, and cognitive impairment among patients with chronic heart failure
Author(s) -
Hjelm Carina,
Strömberg Anna,
Årestedt Kristofer,
Broström Anders
Publication year - 2013
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1093/eurjhf/hft014
Subject(s) - epworth sleepiness scale , medicine , excessive daytime sleepiness , insomnia , actigraphy , cognition , polysomnography , physical therapy , heart failure , sleep apnea , cardiology , sleep disorder , psychiatry , apnea
Aims Chronic heart failure (CHF) and sleep‐disordered breathing (SDB) are often co‐existing problems among the elderly. Apnoeic events may cause cognitive impairment. The aim of the study was to compare sleep and wake patterns, insomnia, daytime sleepiness, and cognitive function in community‐dwelling CHF patients, with and without SDB, and to investigate the association between sleep‐related factors and cognitive dysfunction. Methods and results In this cross‐sectional observational study, SDB was measured with an ApneaLink device and defined as an apnoea–hypopnoea index (AHI) ≥15/h of sleep. Sleep and wake patterns were measured with actigraphy for 1 week. Insomnia was measured with the Minimal Insomnia Symptom Scale, daytime sleepiness with the Epworth Sleepiness Scale, and cognitive function with a neuropsychological test battery. A total of 137 patients (68% male, median age 72 years, 58% NYHA functional class II) were consecutively included. Forty‐four per cent had SDB (AHI ≥15). The SDB group had significantly higher saturation time below 90%, more difficulties maintaining sleep, and lower levels of daytime sleepiness compared with the non‐SDB group. Cognitive function and sleep and wake patterns did not differ between the SDB and the non‐SDB group. Insomnia was associated with decreased global cognition. Conclusion The prevalence of cognitive dysfunction was low in this population with predominantly mild to moderate CHF. This might have influenced the lack of associations between cognitive function and SDB. Insomnia was the only sleep‐related factor significantly influencing cognition.