0706 CONTRIBUTIONS OF INSOMNIA SYMPTOM AND CIRCADIAN RHYTHM OF ACTIVITY PATTERN ON DAYTIME SYMPTOMS AND FUNCTIONAL PERFORMANCE IN STABLE HEART FAILURE PATIENTS

Abstract

Introduction: Daytime symptoms and decrements in functional performance have been explained by insomnia symptoms in stable heart failure (HF) patients and some associations were weaker among older adults. The purpose of this study was to examine associations between insomnia symptoms, daytime symptoms, and functional performance and circadian rhythms of activity-rest patterns among patients with stable HF. Methods: The sample included 132 stable HF patients [66.7% male (M (SD) age = 60.6 ± 16.3 years)]. We collected 24 hour activity with wrist actigraphy (ACT) (Respironics Minimitter Actiwatch 64) over 2-3 days. Difficulty initiating and maintaining sleep (DIMS), multi-dimensional assessment of fatigue scale (MAF), depression (CES-D), Epworth sleepiness scale (ESS), six-minute walk (6MW), and physical function (PF, SF-36) were collected in a cross-sectional study. Generalized linear model (GLM) was performed to test the effect of insomnia symptoms and the circadian quotient on daytime symptoms and functional performance with covariates including age, gender, race, left ventricular ejection faction, NYHA classification, body mass index, respiratory disturbance index, % time at oxygen saturation less than 90%, and comorbidity. The GLMs were repeated in the patients older than 60. Results: Insomnia symptoms are significantly associated with greater fatigue (p=.02) and depression (p