Ceylan Raziye, Demir Rengin, Zeren Melih, Sinan Umit Yasar, Kucukoglu Mehmet Serdar
Institute of Graduate Studies.
Cardiology Institute, Department of Cardiology, Istanbul University-Cerrahpasa, Istanbul.
Acta Cardiol Sin. 2024 Sep;40(5):618-626. doi: 10.6515/ACS.202409_40(5).20240712A.
Poor sleep quality is an overlooked symptom in patients with pulmonary arterial hypertension (PAH), however it may significantly contribute to disease burden.
The aim of this study was to assess the sleep quality of patients with PAH and investigate its association with dyspnea, fatigue, and exercise capacity.
Forty-five patients were included. Sleep quality of the patients was assessed by the Pittsburgh Sleep Quality Index (PSQI), dyspnea levels were assessed by the UCSD-Shortness of Breath Questionnaire (UCSD-SOBQ), Baseline Dyspnea Index (BDI), Modified Medical Research Council (MMRC) dyspnea scale and Modified Borg Dyspnea scale, fatigue levels were evaluated with the Fatigue Severity Scale and Borg Rating of Perceived Exertion, and functional exercise capacity was evaluated with the 6-minute walk test (6MWT).
Among the patients with PAH, 64% had poor sleep quality (PSQI > 5). PSQI score was significantly correlated with MMRC scale (r = -0.561), UCSD-SOBQ (r = 0.497), BDI (r = -0.468), and 6MWT (r = -0.412) (p < 0.05). There was no significant relationship between sleep quality and fatigue. A regression model including MMRC and 6MWT could explain 32% of variance in PSQI (p < 0.05), and MMRC score was an independent predictor for PSQI (p < 0.05). In addition, MMRC score had a greater influence on PSQI than 6MWT (β = 0.548 vs. 0.019).
Poor sleep quality is common in patients with PAH and is associated with poor exercise capacity and dyspnea. Patients with severe dyspnea are particularly at higher risk of poor sleep quality. Consideration of sleep-related complaints and underlying mechanisms when planning symptomatic treatments for these patients may help provide better management for PAH.
睡眠质量差是肺动脉高压（PAH）患者中一个被忽视的症状，然而它可能会显著加重疾病负担。
本研究旨在评估PAH患者的睡眠质量，并调查其与呼吸困难、疲劳和运动能力的关系。
纳入45例患者。通过匹兹堡睡眠质量指数（PSQI）评估患者的睡眠质量，通过加州大学圣地亚哥分校呼吸急促问卷（UCSD-SOBQ）、基线呼吸困难指数（BDI）、改良医学研究委员会（MMRC）呼吸困难量表和改良博格呼吸困难量表评估呼吸困难程度，用疲劳严重程度量表和博格自觉劳累分级评估疲劳水平，用6分钟步行试验（6MWT）评估功能运动能力。
在PAH患者中，64%的患者睡眠质量差（PSQI>5）。PSQI评分与MMRC量表（r=-0.561）、UCSD-SOBQ（r=0.497）、BDI（r=-0.468）和6MWT（r=-0.412）显著相关（p<0.05）。睡眠质量与疲劳之间无显著关系。一个包含MMRC和6MWT的回归模型可以解释PSQI中32%的方差（p<0.05），MMRC评分是PSQI的独立预测因子（p<0.05）。此外，MMRC评分对PSQI的影响大于6MWT（β=0.548对0.019）。
睡眠质量差在PAH患者中很常见，且与运动能力差和呼吸困难有关。严重呼吸困难的患者睡眠质量差的风险尤其高。在为这些患者规划对症治疗时考虑与睡眠相关的主诉和潜在机制可能有助于为PAH提供更好的管理。
