Double jeopardy: The influence of excessive daytime sleepiness and impaired cognition on health-related quality of life in adults with heart failure

Barbara Riegel, Sarah J. Ratcliffe, William S. Weintraub, Steven L. Sayers, Lee R. Goldberg, Sheryl Potashnik, Terri E. Weaver, Susan J. Pressler

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Aims To determine how excessive daytime sleepiness (EDS) and impaired cognition contribute to health-related quality of life (HRQL) in heart failure (HF). Methods and Results Adults with chronic HF were enrolled into a prospective cohort study. Data were obtained from 280 subjects enrolled from three sites in the northeastern USA; 242 completed the 6-month study. At baseline, cohorts with and without EDS were identified using the Epworth Sleepiness Scale. Each EDS group was further subdivided into those with and without impaired cognition using a battery of five neuropsychological tests. Two disease-specific measures, the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the Functional Outcomes of Sleep Questionnaire (FOSQ), were used to measure HRQL. General linear modelling of square-transformed variables was used to test the hypothesis that cohort membership was a significant predictor of HRQL. At 6 months the remaining sample was 62.5 [standard deviation (SD) 12] years old, mostly male (63), white (65), and functionally compromised [72 New York Heart Association (NYHA) class III/IV]. The cohort with both EDS and impaired cognition had the lowest KCCQ overall summary score (60.5 ± 22.5) compared with the cohort without EDS or impaired cognition (74.6 ± 17.4, P ≤ 0.001). A similar effect was seen on the FOSQ (16.0 ± 2.8 vs. 18.5 ± 2.2, P < 0.001). Conclusion Impaired cognition alone did not explain poor HRQL, but the addition of EDS poses a significant risk for poor HRQL. Interventions designed to influence EDS may improve HRQL in this population.

Original languageEnglish (US)
Pages (from-to)730-736
Number of pages7
JournalEuropean Journal of Heart Failure
Volume14
Issue number7
DOIs
StatePublished - Jul 1 2012

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Keywords

  • Cognition
  • Heart failure
  • Quality of life
  • Sleep

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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