Prognostic Impact of Sleep Patterns and Related-Drugs in Patients with Heart Failure

Abstract

Sleep disturbances are frequent among patients with heart failure (HF). We hypothesized that self-reported sleep disturbances are associated with a poor prognosis in patients with HF. A longitudinal study of 119 patients with HF was carried out to assess the association between sleep disturbances and the occurrence of major cardiovascular events (MACE). All patients with HF completed self-administered questionnaires on sleepiness, fatigue, insomnia, quality of sleep, sleep patterns, anxiety and depressive symptoms, and central nervous system (CNS) drugs intake. Patients were followed for a median of 888 days. Cox models were used to estimate the risk of MACE associated with baseline sleep characteristics. After adjustment for age, the risk of a future MACE increased with CNS drugs intake, sleep quality and insomnia scores as well with increased sleep latency, decreased sleep efficiency and total sleep time. However, after adjustment for left ventricular ejection fraction and hypercholesterolemia the HR failed to be significant except for CNS drugs and total sleep time. CNS drugs intake and decreased total sleep time were independently associated with an increased risk of MACE in patients with HF. Routine assessment of self-reported sleep disturbances should be considered to prevent the natural progression of HF.

Role of sleep disorders in patients with cardiovascular disease: A systematic review

“…A total of 66795 references were identified in the two databases. After careful reading, 78 articles were included in this systemic review [ [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] , [80] , [81] , [82] , [83] , [84] , [85] , [86] , [87] , [88] , [89] , [90] ...…”

“… NOS high quality 8 Bitter2011 [ 67 ] Germany Prospective cohort study CHF OSA N = 255 Cardiorespiratory polygraphy In patients with CHF, CSA and OSA are independently associated with an increased risk for ventricular arrhythmias and appropriate cardioverter-defibrillator therapies. NOS high quality AHI≥5h-1 OSA N = 82/67.9 (63.9,73.7)yrs CSA N = 87/68.4 (62.1,72.4)yrs noSDB N = 86/65.7 (56.5,71.6)yrs 9 Bughin2021 [ 76 ] France A longitudinal study HF Sleep patterns N = 119/69yrs PSQI ESS ISI BQ CNS drugs intake and decreased total sleep time were independently associated with an increased risk of MACE in patients with HF. MINORS high quality 10 Calvin2014 [ 72 ] USA Prospective cohort study HF LVEF≤35% CSA N = 46 Polysomnography Increased LAVI is associated with heightened CO 2 chemosensitivity and greater frequency of CSA.…”

“…In this review, 16 studies [ [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] , [80] , [81] ] focused on sleep disorders in patients with HF were included. Four studies [ [66] , [67] , [68] , [69] ] showed that sleep disorders were highly prevalent (31–75.5%) in patients with HF.…”

“…Five [ [71] , [72] , [73] , [74] , [75] ] studies explored several potential predictors of sleep disorders in patients with HF, including left ventricular ejection fraction (LVEF), left atrial volume index (LAVI), and erythropoietin (EPO). Two studies [ 76 , 77 ] showed that sedative-hypnotics for treating sleep disorders presented inconsistent effects in patients with HF, either positive or negative. Four studies [ [78] , [79] , [80] , [81] ] reported several non-drug therapies, including CPAP and CBT-I, for treating sleep disorders in patients with HF.…”