Abstract 14641: Sleep Disturbance is Associated With Lower Quality of Life and Greater Depressive Symptoms in Adults With Congenital Heart Defects
Introduction: Poor sleep quality is common in cardiac populations and known to increase adverse physical and psychological outcomes, but little is known about sleep quality or its association with outcomes in adults with congenital heart defects (ACHD).
Hypothesis: Greater sleep disturbance will be associated with greater depressive symptoms and lower quality of life (QOL) in persons with ACHD.
Methods: A secondary analysis of an observational, self-care study in patients with moderate or severe ACHD (n=125) was conducted. Patients were recruited from a single ACHD center and demographic (age, gender, race, education, employment status, marital status) and clinical data (defect severity, NYHA Class, BMI, Obstructive Sleep Apnea (OSA)), depressive symptoms (PHQ-9), sleep disturbance (PROMIS-Sleep) and overall QOL (VAS scale) were collected by chart review and self-report. Analyses included bivariate correlations and logistic and linear regression.
Results: Patients were mean age 35 years (range 20-68), 56% female, 82% Caucasian, 53% severe ACHD, 26% NYHA Class III/IV, 3% OSA. Sixty-eight (54%) patients reported sleep disturbance (PROMIS t score >50), including low sleep quality, difficulties falling asleep, general sleep problems, and poor sleep refreshment. Persons with sleep disturbance were more likely to be functional NYHA Class III/IV vs I/II (p<.001), have ≤ high school education (p=.02), and be unemployed (p=.02). In univariate analysis, persons with NYHA Class III/IV and lower education were 6.4 and 2.4 times more likely to have sleep disturbance, respectively (OR 6.4, [95% CI 2.2, 18.3]; OR 2.4, [95% CI 1.1, 5.4]). Greater sleep disturbance was related to increased depressive symptoms (β=.65, p<.001) and lower QOL (β=-2.23, p<.001). After adjusting for sociodemographic and clinical variables, sleep disturbance remained independently associated with depressive symptoms (β=.55, p<.001), and QOL (β=-2.25, p=.01).
Conclusions: Sleep disturbance was independently associated with greater depressive symptoms and lower QOL in persons with ACHD. Improving sleep quality may represent an important target for improving psychological and QOL outcomes in ACHD.
Author Disclosures: N. McCabe: Research Grant; Modest; NIH, NINR, T32 Training Grant. W. Book: None. C. Reilly: None. S. Dunbar: None.
- © 2016 by American Heart Association, Inc.