Sleep-disordered Breathing in Cardiac Rehabilitation: Prevalence, Predictors, and Influence on the Six-Minute Walk Test

Background Identification of non-traditional risk factors is an important component of cardiac rehabilitation (CR). However, the prevalence and predictors of sleep-disordered breathing (SDB) and its influence on exercise performance in patients attending CR remain poorly described. Methods Patients...

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Bibliographic Details
Published in:Heart, lung & circulation lung & circulation, 2016-06, Vol.25 (6), p.584-591
Main Authors: Loo, Germaine, MBBS, Chua, Ai-Ping, MBBS, Tay, Hung-Yong, BHSc, Poh, Ruth, Tai, Bee-Choo, PhD, Lee, Chi-Hang, MD
Format: Article
Language:English
Subjects:
Aged
Cardiac Rehabilitation
Cardiology
Cardiovascular
Exercise performance
Female
Humans
Male
Middle Aged
Predictors
Prevalence
Rehabilitation
Respiration
Risk Factors
Screening
Sleep
Sleep Wake Disorders - epidemiology
Sleep Wake Disorders - physiopathology
Sleep Wake Disorders - rehabilitation
Walk Test
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Summary:Background Identification of non-traditional risk factors is an important component of cardiac rehabilitation (CR). However, the prevalence and predictors of sleep-disordered breathing (SDB) and its influence on exercise performance in patients attending CR remain poorly described. Methods Patients enrolled in a national CR centre were eligible for a comprehensive SDB screening program. Screening questionnaires for SDB, overnight sleep study, and the 6-minute walk test (6MWT) were conducted. Results We recruited 332 patients (mean age 62±10 years, 62.4% male) attending CR for primary (29.2%) or secondary (70.8%) prevention, of which 209 successfully completed the overnight sleep study. Sleep-disordered breathing group patients (n=68, 32.5%) were older and had a higher body mass index (BMI) and neck and waist circumferences than the non-SDB group patients. After adjusting for neck and waist circumference, age (OR=1.06; 95% CI 1.02–1.10; p=0.001) and BMI (OR=1.19; 95% CI 1.10–1.30; p10, 23.9% versus 17.7%, p=0.297) were similar between the groups. The 6MWT scores were significantly lower in the SDB than non-SDB group (mean difference -32 m; 95% CI -57–7; p=0.013). The relationship was no longer significant after adjusting for age, sex, and waist circumference. Conclusion Sleep-disordered breathing is prevalent in CR patients and is independently predicted by ageing and obesity. The association between SDB and poorer exercise performance may be explained by age, sex, and waist circumference.
ISSN:1443-9506
1444-2892
DOI:10.1016/j.hlc.2015.12.005