Fatores associados ao padrão de sono pacientes com insuficiência cardíaca / Factors associated with sleep pattern of patients with heart failure

AUTOR(ES)
DATA DE PUBLICAÇÃO

2010

RESUMO

INTRODUCTION: Heart failure (HF) is one of the largest public health problems worldwide, with increasing numbers in any epidemiological analysis. Besides representing a large demand for health services, it is responsible for poor quality of life. Sleep disorders have been described as frequent and common among patients with HF, as well as one of the most troublesome symptoms for this population. OBJECTIVE: To describe sleep patterns in patients with HF and examine associations of sleep pattern with the following variables: gender, age, fatigue, fatigue on exertion, physical activity, functional class, drug therapy, dyspnea, body mass index, and smoking habits. METHODS: A cross sectional study, with a non-probability sample of 400 outpatients (mean age 57.8 years (SD = 11.6), 64.8% men, mean schooling = 6.1 years (SD = 3.9); 82.5% in functional class II or III) under treatment of HF in an academic hospital. Data were collected by interviews in which participants answered a set of tools including: demographic and heart failure data; and assessment of the sleep pattern (PSQI Pittsburgh Sleep Quality Index), fatigue ( Dutch Fatigue Scale - DUFS), fatigue on exertion (Dutch Exertion Fatigue Scale), physical activity (International Physical Activity Questionnaire), and data on dyspnea, smoking habits and drug treatment. Reliability coefficients of the tools in this study were adequate ( PSQI = 0.73; DUFS = 0.90; DEFS = 0.92). Nonparametric tests were applied to analyze the association of sleep patterns with selected variables, and a logistic regression model was adjusted to investigate predictors of poor sleepers. RESULTS: The mean PSQI total score was 8.70 (SD 4.39), the prevalence of poor sleepers (PSQI>5) was 68.5% and 46.5% rated sleep as poor or very poor. Higher PSQI scores or poor sleeper category was associated with: female gender (p = 0.009), unemployement (p = 0.013), fatigue (p = 0.000), fatigue on exertion (p = 0.000), dyspnea (p = 0.000) and higher HF functional class (p = 0.000). Dyspnea (OR=3.23; CI 95% 1.72 to 6.07) and fatigue (OR= 3.45; CI 95% 1.82 to 6.49) were independently associated with the poor sleeper category. CONCLUSIONS: The proportion of poor sleepers among patients with HF is among the highest rates in chronic diseases. Dyspnea and fatigue, commom symptoms in this illness, increase significantly the likelihood of being a poor sleeper. Therefore, the sleep pattern of HF patients has to be routinely assessed.

ASSUNTO(S)

dyspnea heart failure sono fatigue dispnéia enfermagem sleep insuficiência cardíaca nursing fadiga

ACESSO AO ARTIGO

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