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1324: Signs and consequences of obstructive sleep apnea

Background: Patients with chronic heart failure (CHF) have a reduced health-related quality of life (HRQOL) especially if sleep disturbances are involved. Depressive symptoms (DS) has also been described as a prevalent problem in patients with CHF, but few if any studies have focused the relationship to sleep, daytime sleepiness and HRQOL. Aim: To describe the prevalence of self-assessed DS and the relation to sleep, daytime sleepiness and HRQOL in men and women with CHF. Design and sample: Cross sectional design including 212 (129 male and 83 female) patients with CHF, NYHA classification II–IV. Measurements: Self-assessed sleep difficulties (Uppsala Sleep Inventory-CHF), daytime sleepiness (Epworth Sleepiness Scale), and HRQOL (36-Item Short Form Health Survey and Minnesota Living with Heart Failure questionnaire), depressive sympthomatology (MH-5 from the SF-36; cut of <52 indicating depressive symptoms). Findings: A total of 19% of the male and 24% of the female patients suffered from DS. Both male and female patients suffering from DS showed significantly shorter total sleep time, more problems with difficulties initiating and maintaining sleep ( p <0.01), as well as early morning awakenings ( p <0.05) compared to patients without DS. A total of 55% of the patients with DS woke up three times or more, and 11% were awake more than three hours during the night. DS correlated significantly and positively with anxiety during the night (r =0.30, p =0.01), dyspnoea during the night (r =0.26, p =0.01), and a feeling of tachycardia during the night (r =0.33, p =0.01). Almost all dimensions of the SF-36, as well as total and subscale scores for the disease-specific MLWHF showed significantly reduced HRQOL ( p <0.01–0.001) for male and female patients suffering from DS compared to those without DS. Conclusion: Men and women with CHF who suffer from depressive symptoms have a reduced HRQOL, more problems with difficulties initiating and maintaining sleep, as well as early morning awakenings compared to CHF patients without DS.