Sleep and Functional Performance in Heart Failure

心力衰竭的睡眠和功能表现

基本信息

批准号：
7490755
负责人：
Nancy S Redeker
金额：
$ 24.39万
依托单位：
YALE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2003
资助国家：
美国
起止时间：
2003-09-15 至 2009-06-30
项目状态：
已结题

项目摘要

DESCRIPTION (provided by applicant): Heart failure (HF) is well known for its deleterious effects on functional performance and quality of life, and this problem has been persistent despite advances in pharmacological and other treatments. Sleep disturbance, including deceased quantity, fragmentation, and poor self-reported quality, and sleep disordered breathing (Cheyne-Stokes breathing/central apnea and obstructive sleep apnea) are common in HF patients and there is beginning evidence that both sleep and SDB contribute to functional performance. However, the bio-behavior attributes of sleep in HF patients, the contribution of sleep disturbance and SDB to function performance, and the behavioral pathways through which this may occur have not been well explained. Therefore, the purpose of this study is to explicate the nature of sleep disturbance and its contributions to functional performance in a well-defined group of stable HF patients. The specific aims are to: 1. Characterize the physiologic, behavioral, and subjective attributes of sleep in HF patients; 2. Evaluate the contributions of sleep disturbance and SDB (CSB-CSA and OSA) in functional performance of HF patients; 3. Examine the relationships among nocturnal symptoms, sleep disturbance and SDB; and to (1) mood disturbance; (2) excessive daytime sleepiness, and (3) fatigue in HF patients; 4. Evaluate the extent to which fatigue, excessive daytime sleepiness, and mood disturbance mediate the contributions of sleep disturbance to functional performance in HF patients; and 5. Evaluate the influence of age and gender on the relationships between sleep disturbance and functional performance in patients with HF. This project will use a multivariate cross-sectional design and enroll a sample of 400 male and female stable HF patients. Acquisition of sleep and functional performance data in participants' homes, using physiologic, behavioral, and self-report measures, will provide an ecologically valid perspective on sleep and its contribution to functional performance. The use of nocturnal polysomnography will permit a comprehensive examination of sleep itself, as well as sleep disordered breathing. Hypothesized mediator variables will include excessive daytime sleepiness, fatigue, and mood disturbance, measured with well-validated instruments. The potential influences of age, gender, selected clinical variables, and the role of primary sleep disorders (e.g. Cheyne-Stokes breathing and obstructive sleep apnea) on the sleep and the functional performance variables in a multivariate model will be addressed. Multiple regression analysis and structural equation modeling (SEM) will be the primary approaches to data analysis. SEM will be used to evaluate the factor structure of the sleep disturbance construct and serve as a tool to explore the direct and indirect pathways linking the major study variables.

描述（由申请人提供）：心力衰竭（HF）以其对功能性能和生活质量的有害影响而闻名，尽管药理学和其他治疗方面进步了，这个问题仍然持续。在HF患者中，睡眠障碍，包括死者数量，分裂和自我报告的质量不佳以及呼吸失调（Cheyne-Stokes呼吸/中央呼吸暂停和阻塞性睡眠呼吸暂停）在HF患者中很常见，并且有开始的证据表明睡眠和SDB都有助于功能性能。但是，HF患者睡眠的生物行为属性，睡眠障碍和SDB对功能性能的贡献以及可能发生这种情况的行为途径。因此，这项研究的目的是阐明睡眠障碍的性质及其对稳定的HF患者组中功能性能的贡献。具体目的是：1。表征HF患者睡眠的生理，行为和主观属性； 2。评估睡眠障碍和SDB（CSB-CSA和OSA）对HF患者功能性能的贡献； 3。检查夜间症状，睡眠障碍和SDB之间的关系；以及（1）情绪障碍；（2）白天过度嗜睡，（3）HF患者的疲劳； 4。评估疲劳，白天过度嗜睡和情绪干扰的程度，可以介导HF患者的睡眠障碍对功能性能的贡献；和5。评估年龄和性别对HF患者睡眠障碍与功能性能之间关系的影响。该项目将使用多元横截面设计，并招募400名男性和女性稳定HF患者的样本。使用生理，行为和自我报告措施，在参与者家中获取睡眠和功能性能数据将提供有关睡眠的生态有效观点及其对功能性能的贡献。使用夜间多孕症术的使用将允许对睡眠本身进行全面检查，以及睡眠障碍的呼吸。假设的调解器变量将包括白天嗜睡，疲劳和情绪干扰，并用验证良好的仪器测量。年龄，性别，选定的临床变量的潜在影响以及原发性睡眠障碍（例如Cheyne-Stokes呼吸和阻塞性睡眠呼吸暂停）的作用以及多元模型中功能性能变量的潜在影响。多元回归分析和结构方程建模（SEM）将是数据分析的主要方法。 SEM将用于评估睡眠障碍构建体的因子结构，并用作探索与主要研究变量联系的直接和间接途径的工具。

项目成果

期刊论文数量（11）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Sleep Disturbance, Daytime Symptoms, and Functional Performance in Patients With Stable Heart Failure: A Mediation Analysis.

DOI：
10.1097/nnr.0000000000000169
发表时间：
2016-07
期刊：
Nursing research
影响因子：
2.5
作者：
Jeon S;Redeker NS
通讯作者：
Redeker NS

Nocturia, sleep and daytime function in stable heart failure.

DOI：
10.1016/j.cardfail.2012.05.002
发表时间：
2012-07
期刊：
JOURNAL OF CARDIAC FAILURE
影响因子：
6
作者：
Redeker, Nancy S.;Adams, Laura;Berkowitz, Robert;Blank, Lenore;Freudenberger, Ronald;Gilbert, Michele;Walsleben, Joyce;Zucker, Mark J.;Rapoport, David
通讯作者：
Rapoport, David

Rest-activity rhythms, daytime symptoms, and functional performance among people with heart failure.