Clinical InvestigationNocturia, Sleep and Daytime Function in Stable Heart Failure
Section snippets
Design
We conducted a cross-sectional study to evaluate the study aims. This report was part of a larger study that had the overall purpose of evaluating the extent to which sleep and SDB explained daytime symptoms and functional performance. Full details of the study design and methods have been previously published9, 19 but are summarized here as relevant to the present report.
Sample
The sample included patients with stable HF recruited from 5 specialized HF disease management programs in the northeastern
Sample Characteristics
The sample consisted of 173 patients who had stable HF (mean left ventricular ejection fraction [LVEF] 32.6 ± 15.2%; mean age 60.35 ± 16.07 years; women n = 60 [35%]). The sample included 110 (63.6%) European, 50 (29%) African, 7 (4%) Asian, and 10 (6%) Latino participants. The majority of participants used diuretics, including loop (n = 139; 80.3%), thiazides (n = 29; 16.7%), and potassium-sparing (n = 50; 28.9%) drugs. Detailed information on the clinical comorbidity and additional
Discussion
Nocturia is common and often severe in patients with stable HF. A full one-third of patients awakened ≥3 times per night to void. The prevalence of nocturia concurrent with the PSG recording is consistent with the report of another study of HF patients,1 but the rate of habitual nocturia is lower, and there are no comparative data on the nocturia severity as indicated by voiding frequency (such as measured in the present study) in patients with HF. Prevalence rates are higher than rates
Acknowledgments
The authors acknowledge the assistance of Laura Andrews, Nancy Bonnet, Della Campbell, George Evans, Marybeth Gregory, Rakiel Kanayefska, Agha Khan, Syed Naqvi, Eileen Oates, Rubab Qureshi, Leonie Rose, Alison Rosen, Leslie Faith Morritt-Taub, and Teresa Williams.
Disclosures
None.
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Cited by (40)
Neurological complications of heart failure
2021, Handbook of Clinical NeurologyCitation Excerpt :It may be caused by adverse effects of commonly prescribed HF medications, such as diuretics and β-blockers (Jimenez et al., 2011). Nocturia is also commonly associated with orthopnea (Redeker et al., 2012). Sleep-disordered breathing is highly prevalent in patients with HF.
Cognitive behavioral therapy for insomnia in stable heart failure: Protocol for a randomized controlled trial
2017, Contemporary Clinical TrialsCitation Excerpt :Predisposing and precipitating factors for insomnia are poorly understood, but they are likely multi-factorial. Aging and gender often predispose to insomnia, but among HF patients, age, gender [2,3], left ventricular ejection fraction (LVEF) [2], cardiac medications [18], and sleep apnea (SA) were not associated with chronic insomnia [3,19]. Because these factors and comorbidity may contribute to insomnia and other study outcomes, they will be explored as possible covariates (Fig. 1).
Prognostic importance of sleep quality in patients with heart failure
2016, American Journal of Critical CareCitation Excerpt :Its prevalence can be as high as 86.5% in patients with heart failure.13,39 Patients who often woke up more than twice per night for urination were more likely than other patients to have impaired sleep efficiency and to experience severe daytime sleepiness.39 Because evening doses of diuretics or fluid intake in the late evening contributes to nocturia,19 clinicians need to adjust timing for doses of diuretics and evaluate patients’ patterns of fluid consumption to alleviate nocturia-related sleep disturbance.
Self-reported quantity and quality of sleep in children and adolescents with a chronic condition compared to healthy controls
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Funding: National Institutes of Health R01NR008022.
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