Department of Cardiology, Linköping University Hospital, S-58185 Linköping, Sweden.
Eur J Cardiovasc Nurs. 2010 Jun;9(2):108-17. doi: 10.1016/j.ejcnurse.2009.11.005. Epub 2010 Jan 6.
The aims of this study are (I) to compare the prevalence of sleep disordered breathing (SDB) and insomnia between elderly with heart failure (HF) and age and gender matched elderly without cardiovascular disease (CVD), and (II) to examine the association between HF, SDB and insomnia, as well as their impact on health related quality of life (Hr-QoL).
Three hundred and thirty-one elderly (71-87 years) community-living individuals underwent sleep recordings and echocardiography. Questionnaires assessed insomnia and Hr-QoL. Comparisons were made between age and gender matched individuals with HF (n=36) and without CVD (n=36).
The HF group had higher mean apnoea-hypopnoea index (17.6 vs. 6.3, p<0.001). Moderate/severe SDB was found in 42% of those with HF vs. 8% in those without CVD (p=0.001). Those with HF had more difficulties maintaining sleep (DMS) (72% vs. 50%, p=0.05) and excessive daytime sleepiness (EDS) (25% vs. 8%, p=0.05) and scored worse Hr-QoL in five of eight SF-36 domains. In regression analysis SDB had no association to Hr-QoL. DMS associated to the physical-, and non restorative sleep to the mental domain of Hr-QoL. SDB had no correlations to insomnia or EDS.
SDB, DMS and EDS are more common in elderly with HF. SDB is not an obvious cause for sleep complaints or poor Hr-QoL in elderly.
本研究旨在：(I)比较老年心力衰竭（HF）患者与年龄和性别相匹配的无心血管疾病（CVD）老年人之间睡眠呼吸障碍（SDB）和失眠的患病率；(II) 检查 HF、SDB 和失眠之间的关系，以及它们对健康相关生活质量（Hr-QoL）的影响。
331 名社区居住的老年人（71-87 岁）接受了睡眠记录和超声心动图检查。调查问卷评估了失眠和 Hr-QoL。在年龄和性别匹配的 HF 患者（n=36）和无 CVD 患者（n=36）之间进行了比较。
HF 组的平均呼吸暂停低通气指数（17.6 比 6.3，p<0.001）更高。HF 组中有 42%的人存在中度/重度 SDB，而无 CVD 组中只有 8%的人存在中度/重度 SDB（p=0.001）。HF 患者睡眠维持困难（DMS）（72%比 50%，p=0.05）和白天过度嗜睡（EDS）（25%比 8%，p=0.05）的情况更为严重，且在 SF-36 的八个领域中有五个领域的 Hr-QoL 评分更差。在回归分析中，SDB 与 Hr-QoL 无关。DMS 与身体域相关，非恢复性睡眠与心理域相关。SDB 与失眠或 EDS 无相关性。
SDB、DMS 和 EDS 在老年 HF 患者中更为常见。SDB 不是老年患者睡眠问题或 Hr-QoL 较差的明显原因。
