1033 Sleep and Patient-Reported Outcomes in Persons With Heart Failure With Preserved Ejection Fraction

Abstract

Introduction Sleep quality has a significant bearing on disease. A better understanding of sleep quality may help identify opportunities to improve patient-reported outcomes (PROs) in persons with heart failure with preserved ejection fraction (HFpEF). We aimed to explore the association between sleep and PROs in patients clinically diagnosed with HFpEF. Methods Cross-sectional study of 22 participants (71.2±7.2 years, 95% male, 86.4% white) with HFpEF, recruited from a heart failure (n=14) and sleep clinic (n=8). Sleep disordered breathing was measured objectively using one-night in-home obstructive sleep apnea (OSA) testing (ApneaLink). Actigraphy (7 days) was used to assess sleep duration, efficiency, and wake after sleep onset (WASO). Subjective sleep measures included the Insomnia Severity Index (ISI), Epworth Sleepiness scale (ESS), and Pittsburgh Sleep Quality Index (PSQI). PROs included functional status (Functional Outcomes Sleep Questionnaire [FOSQ]), depression (PROMIS Depression), fatigue (PROMIS Fatigue), and heart failure specific quality of life (Kansas City Cardiomyopathy Questionnaire [KCCQ]; overall summary score [KCCQ-os] and clinical summary score [KCCQ-cs]). The KCCQ-cs includes physical function and symptom scores to corresponds with NYHA Classification. Results Fifty percent of the participants had poor sleep quality (PSQI >5) and 2 (9.1%) had ISI scores >14. The majority (64%; n=14) had OSA; 10 currently on OSA therapy. Mean oxygen desaturation index (ODI) was 20.8±17.8. Mean actigraphy data indicated poor sleep (sleep duration 302±116 minutes, sleep efficiency 70.0±18.6%, and WASO 52±28 minutes) despite only 5 (22.7%) participants reporting excessive daytime sleepiness (ESS>10). Greater insomnia symptom severity was associated with lower heart failure specific quality of life (KCCQ-os) and functional status, and, greater fatigue and depression (all p-values