The Impact of Sleep Apnea on Heart Failure Patients

Wednesday, 1 August 2012

Ubolrat Piamjariyakul, PhD, RN
School of Nursing, University of Kansas Medical Center, Kansas City, KS
Carol E. Smith, PhD, FAAN, RN
School of Nursing, University of Kansas, Kansas City, KS

Learning Objective 1: 1) assess the sleep apnea among HF patients.

Learning Objective 2: 2) identify the associated health-related problems of sleep apnea among HF patients.


To describe the characteristics of HF patients who were diagnosed with sleep apnea and to compare the associated health-related problems between HF patients who had sleep apnea with those who did not.


The sample was comprised of 198 patients who participated in an NHLBI randomized clinical trial testing nurse practitioner-facilitated group clinic appointments. Subjects were 24-101 years of age (M=62.3, SD=13.2 years), 62% male, and 44% African Americans. The baseline data were collected by questionnaires and a semi-structured telephone interview. The data on sleep apnea was retrieved from the screening chart reviews. Data analysis was conducted using descriptive and t-test statistics. Questionnaires used were: Kansas City Cardiomyopathy Questionnaire (KCCQ), Health Functional Status (SF-12), Epworth Sleepiness, Depression (CES-D), and Charlson Comorbidity Index.


Of the 198 participants enrolled, 62 had a medical diagnosis of sleep apnea. About 76% (n=47) were diagnosed with obstructive sleep apnea. Of those diagnosed with sleep apnea, 40 (64.5%) used Continuous Positive Airway Pressure (CPAP) or Bilevel Positive Airway Pressure (BiPAP) to treat their sleep apnea. However, the number of hours per night using CPAP/BiPAP mask was unknown or unreported. Participants who had sleep apnea had significantly higher scores on Charlson Comorbidity Index (p<.01) and daytime sleepiness (p<.05), and significantly worse scores on HF symptom experience on KCCQ subscales (p<.05 to p<.001) and physical functional status (p<.01). No significant difference was found on the CES-D between groups.


Aligned with other studies, patients with sleep apnea had greater morbidity and worse scores on symptom experience. The lack of significant differences on depression and other subscales may be due to the impact of CPAP use. These findings will be used to guide further analysis on HF outcomes (mortality and re-hospitalization) and health care costs.