Abstract 21589: Factors Associated with Daytime Sleepiness in Heart Failure Patients With Kidney Disease
Chronic kidney disease (CKD) is a strong predictor of adverse events in heart failure (HF) patients. Elements related to the kidney disease process could be contributing to daytime sleepiness and poor outcomes. The purpose of this study was to identify factors associated with daytime sleepiness in HF patients with CKD.
Methods: After excluding patients on dialysis and those with severe depression, dementia, a prior neurologic event, terminal illness, recent drug or alcohol abuse, and night shift workers, 280 adults with a confirmed HF diagnosis were enrolled. This study focuses on the 124 with moderate or severe CKD defined as an estimated glomerular filtration rate (eGFR) <60mg/dl/1.73m2 as calculated by the new CKD Epidemiology equation. Daytime sleepiness was defined as an Epworth Sleepiness Scale score >10. The following variables were considered: age, gender, race, NYHA class, hemoglobin, eGFR, systolic and diastolic blood pressure, body mass index, Charlson comorbidity index, and number of medications causing somnolence.
Results: The sample (n=124) was 72% male, 56.5% white, 66% NYHA class III, mean age 68± 10.2years, mean eGFR 41.3± 11.9mg/dl/1.73m2. Factors significantly associated with daytime sleepiness in bivariate analyses were eGFR (p=0.008) and hemoglobin level (p=0.02). In the final regression model, eGFR (OR=1.054, P=0.025) was the only significant predictor of daytime sleepiness.
Conclusion: Daytime sleepiness should be suspected in patients with HF and CKD, with particular focus on earlier CKD. Further research is needed to understand these clues about mechanisms underlying daytime sleepiness in persons with HF and moderate or severe CKD.
- © 2010 by American Heart Association, Inc.