Hedlund Eva R, Villard Li, Lundell Bo, Sjöberg Gunnar
Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Department of Physiotherapy, Karolinska University Hospital, Stockholm, Sweden.
Cardiol Young. 2019 Jul;29(7):922-929. doi: 10.1017/S1047951119001136. Epub 2019 Jun 20.
To study physical activity and sleep in Fontan patients and healthy controls before and after an endurance training program, and after 1 year.
Fontan patients (n = 30) and healthy controls (n = 25) wore accelerometers for seven consecutive days and nights during a school week before and after a 12-week endurance training program and after 1 year.
Patients had similar sleep duration and sleep efficiency as healthy controls. Latency to sleep onset in minutes was longer for patients than controls (22.4 (4.3-55.3) minutes versus 14.8 (8.6-29.4) minutes, p < 0.01). More time in moderate-to-vigorous activity daytime was correlated with increased sleep time (p < 0.05; r2 = 0.20), improved sleep efficiency (p < 0.01; r2 = 0.24) and less time as wake after sleep onset (p < 0.05; r2 = 0.21) for patients but not controls. Sleep variables did not change after the exercise intervention for patients or controls. After 1 year, patients had decreased total sleep time, decreased sleep efficiency, increased accelerometer counts during sleep and more time as wake after sleep onset during sleep time, but not controls.
Fontan patients have prolonged latency to sleep onset compared with controls. More time in physical activities was correlated with better sleep quality for the patients. Also, subjects with low sleep efficiency and long latency to sleep onset may benefit most from physical exercise. These patients should be encouraged to engage in individually designed physical exercise as this could improve sleep quality.
研究在耐力训练计划前后以及1年后，Fontan手术患者和健康对照者的身体活动及睡眠情况。
Fontan手术患者（n = 30）和健康对照者（n = 25）在为期12周的耐力训练计划前后以及1年后的一个上学周内，连续7个昼夜佩戴加速度计。
患者的睡眠时间和睡眠效率与健康对照者相似。患者入睡潜伏期（以分钟计）比对照者长（22.4（4.3 - 55.3）分钟对14.8（8.6 - 29.4）分钟，p < 0.01）。患者白天中度至剧烈活动时间增加与睡眠时间增加（p < 0.05；r2 = 0.20）、睡眠效率提高（p < 0.01；r2 = 0.24）以及入睡后觉醒时间减少（p < 0.05；r2 = 0.21）相关，但对照者无此情况。运动干预后，患者和对照者的睡眠变量均未改变。1年后，患者总睡眠时间减少、睡眠效率降低、睡眠期间加速度计计数增加且睡眠期间入睡后觉醒时间增加，但对照者无此情况。
与对照者相比，Fontan手术患者入睡潜伏期延长。患者进行更多的体育活动与更好的睡眠质量相关。此外，睡眠效率低和入睡潜伏期长的受试者可能从体育锻炼中获益最大。应鼓励这些患者进行个体化设计的体育锻炼，因为这可以改善睡眠质量。
