College of Nursing, Dayanand Medical College & Hospital, Ludhiana, Punjab, India.
J Cardiovasc Nurs. 2011 Nov-Dec;26(6):452-9. doi: 10.1097/JCN.0b013e31820a048e.
Stable congestive heart failure (CHF) patients frequently suffer from sleep apnea, which worsens the prognosis of heart failure and affects sleep quality of the patient. The present study was undertaken to assess the prevalence of obstructive sleep apnea (OSA) and associated quality of life (QOL) among CHF patients and to ascertain the relationship of OSA with excessive daytime sleepiness and selected demographic, clinical, and anthropometric characteristics.
Fifty CHF patients and 50 healthy controls were conveniently recruited at CHF clinic, cardiothoracic and neurosciences center outpatient department, All India Institute of Medical Sciences, New Delhi, India. Participants were interviewed using Epworth Sleepiness Scale, Modified Berlin Questionnaire, Kansas City Cardiomyopathy Questionnaire, and Quebec Sleep Questionnaire.
The present study revealed 18% and 8% prevalence of OSA in the CHF and control groups, respectively. The prevalence of OSA was comparable in males and females. Excessive daytime sleepiness was significantly associated with OSA in CHF patients (P = .02). Clinical severity (New York Heart Association class) and duration of illness were not significantly associated with OSA. Increased body mass index and neck circumference were the significant risk factors responsible for OSA. Quality of life of CHF patients was poor, and OSA had a significantly negative impact on the already compromised QOL in CHF patients as well as in individuals with no CHF.
Prevalence of OSA is high in CHF patients as well as in the general population, and it has negative impact on the already compromised QOL of CHF patient; therefore, assessment of the risk of OSA and referral for appropriate treatment should be a part of routine nursing clinical workup. Nursing interventions should also be planned to improve sleep quality of CHF patients.
稳定充血性心力衰竭（CHF）患者常患有睡眠呼吸暂停，这会恶化心力衰竭的预后并影响患者的睡眠质量。本研究旨在评估 CHF 患者中阻塞性睡眠呼吸暂停（OSA）的患病率以及与生活质量（QOL）的关系，并确定 OSA 与白天过度嗜睡以及选定的人口统计学，临床和人体测量特征的关系。
在印度新德里全印度医学科学研究所的 CHF 诊所，心胸和神经科学中心门诊部门方便地招募了 50 名 CHF 患者和 50 名健康对照者。使用 Epworth 嗜睡量表，改良柏林问卷，堪萨斯城心肌病问卷和魁北克睡眠问卷对参与者进行访谈。
本研究显示 CHF 和对照组的 OSA 患病率分别为 18％和 8％。男女之间 OSA 的患病率相当。白天过度嗜睡与 CHF 患者的 OSA 显着相关（P =.02）。临床严重程度（纽约心脏协会分级）和疾病持续时间与 OSA 无显着相关性。体重指数和颈围增加是导致 OSA 的重要危险因素。CHF 患者的生活质量较差，OSA 对 CHF 患者以及没有 CHF 的个体已经受损的 QOL 产生了重大负面影响。
CHF 患者以及普通人群中 OSA 的患病率很高，并且对已经受损的 CHF 患者的 QOL 产生负面影响；因此，评估 OSA 的风险并转介进行适当的治疗应成为常规护理临床评估的一部分。还应计划护理干预措施，以改善 CHF 患者的睡眠质量。
