Determinants of Excessive Daytime Sleepiness and Fatigue in Adults With Heart Failure

Abstract

Little is known about excessive daytime sleepiness (EDS) in heart failure (HF). The aim of this cross-sectional descriptive study was to describe the prevalence of EDS and factors associated with it in HF. A secondary purpose was to explore the correlates of fatigue. We enrolled a consecutive sample of 280 adults with a confirmed diagnosis of chronic HF from three outpatient settings in the northeastern US. Patients with major depressive illness were excluded. Clinical, sociodemographic, behavioral, and perceptual factors were explored as possible correlates of EDS. Using an Epworth Sleepiness Scale score >10, the prevalence of EDS was 23.6%. Significant determinants of EDS were worse sleep quality (p=0.048), worse functional class (p=0.004), not taking a diuretic (p=0.005), and lack of physical activity (p=0.04). Only sleep quality was associated with fatigue (p<0.001). Sleep disordered breathing was not significantly associated with EDS or with fatigue. These factors may be amenable to intervention.

Daytime sleepiness in renal transplant recipients is associated with immunosuppressive non‐adherence: a cross‐sectional, multi‐center study

“…The current study's DS prevalence, as assessed with the ESS, was 50.8% using a cut‐off of ≥6 and 21.3% with a cut‐off of ≥10. This prevalence is higher than in the general population, which ranges from 1.4% to 8% , yet lower than those reported (ESS cut‐off ≥10) in other chronically ill populations, for example, hemodialysis (27%) , heart failure (23.6%) , gastro‐esophageal reflux disease (48.8%) , and primary biliary cirrhosis (51%) . Our multivariate model showed that higher DS scores were associated with more immunosuppressive NA.…”

The Correlation Between Fatigue and Sleep Quality among Patients with Heart Failure

“…In this study, the more fatigue is perceived, the poorer the sleep quality experienced by participants, similar to the finding from the previous study by Nasiri et al (2016). Some studies also confirmed the associations of fatigue and global PSQI score using different kind of fatigue measurements (Dos Santos et al, 2011, Fink et al, 2012, Riegel, 2012.…”

“…This study showed that the higher the daytime dysfunction, the more severity, distress, interference in ADL, and longer fatigue participants had. Riegel (2012) found that patients with HF with worse daytime dysfunction are more likely to have fatigue. The findings suggest that daytime dysfunction may result in altered daily activities and recreational life.…”

Heart failure symptom clusters and functional status – a cross‐sectional study

“…Excessive daytime sleepiness, a consequence of sleep disturbance, was chosen as a variable in this study because of its prevalence in individuals with heart failure (Reddeker & Stein ) and association with worse functional status and lack of physical activity (Riegel et al . ). In the present study, Cronbach's alpha on this subscale was 0·74.…”