Abstract 9688: Sleep Quality is a Significant Determinant of Executive Attention in Adults With Heart Failure
Background: Cognitive impairment is found in 25-50% of adults with heart failure (HF). Attention is an essential component of neurocognitive functioning and very sensitive to inadequate sleep. Little is known about attention in HF relative to sleep disturbances, but in the general population women have more sleep disturbances than men. So, the purpose of this study was to identify factors associated with attention in adults with HF and determine if gender differences exist.
Methods: Using a cross-sectional observational design, a sample of 280 adults with chronic HF was enrolled from 3 out-patient settings in the northeastern US. Patients were excluded if they had significant cognitive impairment (measured on TICS) or significant depression (PHQ-9). Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). Attention was measured as neurobehavioral response speed (RS) on the psychomotor vigilance test (PVT)-a well-validated measure of vigilant attention deficits relative to sleep loss. General linear modeling (GLM) was performed separately by sex to identify significant determinants of RS.
Results: Overall sleep quality was worse in women (mean 7.8±4.1, 95% CI 7.0-8.6) than men (mean 6.9±4.0, CI 6.3-7.5). Response speed was slower in women (mean 3.0 ± .73 sec, CI 2.9-3.1]) than in men (mean 3.2±.73 sec, CI 3.2-3.3]). A model of 3 variables explained 28.7% of the variance in PVT RS in women (n=100, mean age 60±12.7, 36% Black): higher PSQI daytime dysfunction from poor sleep, higher alcohol intake, and lower education levels predicted slower RS. In men (n=180, mean age 63±12.3, 33% Black), 4 variables explained 53% of the variance in PVT RS. Significant predictors of slower RS in men were worse PSQI sleep efficiency, higher PSQI daytime dysfunction from poor sleep, higher creatinine, and taking more medicines.
Conclusions: Reduced sleep quality, as indexed by higher daytime dysfunction complaints due to poor sleep, was a significant determinant of psychomotor speed during vigilant attention performance in both women and men with HF. Sleep quality can be modified; interventions designed to improve sleep quality may improve RS and cognition in HF patients.
- © 2013 by American Heart Association, Inc.