Sleep quality in Patient with Heart failure: A cross-sectional study

心臟衰竭病患與睡眠品質相關性之探討

張嘉修(Chia-Hsiu Chang) ； 張晉胤(Jin-Yin Chang) ； 徐翠文(Tsui-Wen Hsu)

《輔仁醫學期刊》 16卷4期 (2018/12) Pp. 153-161

https://doi.org/10.3966/181020932018121604001

摘要

Background: Patients with Heart failure (HF) and sleep disordered breathing influence health-related quality of life (HRQOL). However, the objective characteristics of sleep in HF patients which related to HRQOL remain unclear. Objectives: This study is to identify and correlates quality of sleep and related factors in patients with HF in Taiwan. Methods: Adult patients (aged ≥20 years) with a current diagnosis of Heart failure, who voluntarily elected (n=200), were evaluated within single medical center. This study was a cross-sectional study based on consecutive hospitalized HF patients in Cathay General Hospital, Taiwan. HRQOL was assessed by using the Pittsburgh sleep Quality Index (PSQI). The cut-off point for PSQI score ≤ 5 were defined as good sleep quality. Results: Seventy-two percent of patients (n = 144) reported poor sleep quality (PSQI ＞ 5) at baseline with a mean global PSQI score of 8.48. Also, a significant relationship was found between PSQI scores and patients’ age (p＜0.05), Comorbidity (p＜ 0.01), NHYA class (p＜ 0.01), Marital status (p＜ 0.03). When covariates of age, gender, BMI, left ventricular ejection fraction (LVEF), and New York Heart Association (NYHA) functional class were entered, Multivariate logistic regression for sleep quality showed that New York Heart Association (NYHA) class IV heart disease was still a significant risk factor (odds ratio=2.31, 95% confidence interval, 1.38-3.88). Moreover, the score of each component of PSQI might increase as NYHA class worsens. Conclusions: The NHYA class IV was the most significant factor for sleep quality in HF patient.

關鍵字

Heart failure ； Pittsburgh sleep Quality Index ； health-related quality of life

並列摘要

背景和目的：心臟衰竭是漸進惡化的疾病，合併睡眠障礙將導致影響生活品質及加速疾病的進展，如何增加生活品質以改善睡眠及延長生命極為重要。本研究即希望找出影響睡眠品質的因素。方法：採用橫斷式研究設計，以匹茲堡睡眠品質指標量表問卷收集資料，立意取樣年滿二十歲且診斷為心臟衰竭病人之患者，共收案200為病人。結果：年齡、睡眠、婚姻、合併症及紐約心臟學會功能分級第四級者睡眠品質有差異兩組有顯著差異（OR=2.31, 95% CI=1.38-3.88），P值小於0.05；離婚男性及已婚女性之C反應蛋白（CRP）有顯著差異，P值小於0.05。結論：本研究可提供心臟衰竭病人之生活品質及相關因素的探討的資料，作為改善睡眠生活品質之依據。

並列關鍵字

心臟衰竭 ； 匹茲堡睡眠問卷 ； 生活品質