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Effects of long-term nocturnal oxygen treatment in patients with severe heart failure
Linköping University, Department of Medicine and Care, Cardiology. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Care, Cardiology. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Care, Pulmonary Medicine. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Care, Cardiology. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0001-7431-2873
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2005 (English)In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 20, no 6, 385-396 p.Article in journal (Refereed) Published
Abstract [en]

Sleep-disordered breathing (SDB) is common in patients with heart failure (HF) and leads to disturbed sleep. The objective of this study was to determine the persistent effects of long-term nocturnal oxygen treatment in patients with severe HF regarding (1) objective outcomes, such as sleep, SDB, cardiac function, and functional capacity; (2) subjective outcomes, such as self-assessed sleep difficulties, daytime sleepiness, and health-related quality of life (HRQOL); and (3) the relationship between objective and subjective outcomes. In this open nonrandomized experimental study, 22 patients, median age 71 years, with severe HF were studied before and after 3 months of receiving nocturnal oxygen. The measures used were overnight polysomnography, echocardiography, 6-minute walk test, self-assessed sleep difficulties (Uppsala Sleep Inventory-HF), daytime sleepiness (Epworth Sleepiness Scale), and HRQOL (36-Item Short Form Health Survey and Minnesota Living with Heart Failure Questionnaire). SDB, with a 90% dominance of central sleep apnea, occurred in 41% of the patients with severe HF before intervention. After intervention, functional capacity improved for both the whole group of patients with HF (P < .01) and HF patients with SDB (P < .05). No improvements regarding cardiac function, objective sleep, subjective sleep, or SDB were seen, except for a decrease of > or = 4% desaturations (P < .05). HRQOL did not differ significantly between HF patients with and without SDB before or after intervention with nocturnal oxygen. Long-term nocturnal oxygen treatment improved functional capacity in patients with severe HF, with or without SDB. No improvements were seen regarding sleep, daytime sleepiness, SDB, cardiac function, or HRQOL.

Place, publisher, year, edition, pages
2005. Vol. 20, no 6, 385-396 p.
Keyword [en]
chronic heart failure, functional capacity, health-related quality of life, oxygen treatment, sleep, sleep-disordered breathing
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-31574PubMedID: 16485622Local ID: 17375OAI: oai:DiVA.org:liu-31574DiVA: diva2:252397
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13
In thesis
1. Sleep and health-related quality of life in patients with chronic heart failure and their spouses: a descriptive and interventional study
Open this publication in new window or tab >>Sleep and health-related quality of life in patients with chronic heart failure and their spouses: a descriptive and interventional study
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The general aim of this thesis was to describe and compare the sleep situation and health-related quality of life in patients with chronic heart failure and their spouses, as well as to evaluate the effects of an intervention with 3-months ofhome based oxygen treatment. Descriptive designs were used to describe how patients with chronic heart failure conceived their sleep situation (I), decisive situations that influenced spouses' support to patients with chronic heart failure in relation to the couple's sleep situation (II), and self-assessed sleep difficulties, daytime sleepiness and their relation to health-related quality oflife in men and women with chronic heart failure, as well as to make a comparison with data from a norm population (III). An interventional design was used to determine the effects of 3-months of home based oxygen treatment regarding both subjective and objective outcomes (IV).

Daily life, the disease itself and cardiac symptoms influenced the sleep situation and led to ensuing effects, such as fatigue, listlessness, loss of temper, loss of concentration, a need for daytime sleep, seclusion, information and counseling. Patients handled their sleep disturbances by means of support from their psychosocial environment as well as coping mechanisms related to developed patterns of daily life (I). Decisive situations inhibited or stimulated spouses' support to patients with heart failure, in relation to the couples' sleep situation (II). Self-assessed sleep difficulties such as difficulties initiating sleep, difficulties maintaining sleep, and excessive daytime sleepiness were common in patients with chronic heart failure and gave a decreased health-related quality of life compared to chronic heart failure patients without sleeping difficulties (III). Sleep disordered breathing, with a dominance of central sleep apnea was a very common problem, with a high prevalence, but patients suffering from objectively registered sleep disordered breathing did not show decreased health-related quality of life compared to chronic heart failure patients without sleep disordered breathing. A long-term intervention with nocturnal home based oxygen improved functional exercise capacity for both the whole group of patients with chronic heart failure, as well as in patients with chronic heart failure where sleep disordered breathing occurred. The intervention did not give any persistent improvements regarding cardiac function, objective sleep, subjective sleep, sleep disordered breathing, or healthrelated quality of life (IV).

Sleep disturbances are a complex situation where sleep disordered breathing can be seen as one possible organic trigger, together with psychosocial, as well as environmental factors causing a chain reaction with disturbed sleep, daytime sleepiness and decreased health-related quality of life that leads to physical, social, and mental consequences and needs. Further studies are therefore needed from a holistic perspective on both patients with chronic heart failure and their spouses.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2004. 70 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 836
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-23506 (URN)2970 (Local ID)91-7373-807-7 (ISBN)2970 (Archive number)2970 (OAI)
Public defence
2004-03-04, Aulan, Hälsans Hus, Hälsouniversitet, Linköping, 09:00 (Swedish)
Opponent
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2012-10-29Bibliographically approved

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Broström, AndersHübbert, LailaJakobsson, PerJohansson, PeterDahlström, Ulf

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