Abstract 5908: Prognostic Significance of Poor Sleep Quality in Patients Referred to a Heart Failure Clinic
PURPOSE To assess whether poor sleep quality carries prognostic significance for patients with suspected heart failure (HF).
METHODS Data from patients referred to a HF clinic between July 2001 and October 2006 was analysed in a Cox Regression model to assess the prognostic significance of sleep quality. Patient responses for 3 questions addressing sleep quality (difficulty going to sleep, waking up in the night, and lack of refreshing sleep) were used to generate a sleep quality score (SQS) of 1 (none or minimal sleep impairment, N= 1054); 2 (mild to moderate sleep impairment, N= 908); or 3 (severe sleep impairment, N= 644).
RESULTS Of 2606 patients, 59% were male. Median age was 72 yrs (Interquartile range (IQR) 65–78). There were 549 deaths during a median follow up of 37.5 months (IQR 26–46.4). Kaplan Meier survival curves showed that SQS 3 was associated with significantly worse prognosis (Figure 1⇓), and this association persisted despite correction for age, sex, NYHA class, severity of LV systolic dysfunction, BMI, pulse pressure, lab parameters (sodium, creatinine, haemoglobin, NTproBNP, CRP and cholesterol), medication use (loop diuretics, ACE inhibitors, beta-blockers, statins and aldosterone antagonists) and comorbidities (diabetes, hypertension, AF, IHD, COPD and CVA)(Table 1⇓).
CONCLUSION Poor sleep quality is an independent prognostic marker in patients referred to a HF clinic.