Sleep Quality, Depression, and Quality of Life in Patients with Pulmonary Hypertension

• Published in: Lung 2011-04, Vol.189 (2), p.141-149
• Main Authors: Batal, Omar, Khatib, Omar F, Bair, Nancy, Aboussouan, Loutfi S, Minai, Omar A
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Analysis; Camphor; Care and treatment; Case-Control Studies; Cross-Sectional Studies; Depression - epidemiology; Depression - physiopathology; Depression - psychology; Development and progression; Female; Health Surveys; Humans; Hypertension; Hypertension, Pulmonary - complications; Hypertension, Pulmonary - physiopathology; Hypertension, Pulmonary - psychology; Insomnia; Male; Medicine; Medicine & Public Health; Mental depression; Middle Aged; Pneumology/Respiratory System; Prevalence; Pulmonary arteries; Pulmonary hypertension; Quality of life; Quality of Life - psychology; Regression Analysis; Respiratory Function Tests; Risk Factors; Sleep; Sleep quality; Sleep Wake Disorders - epidemiology; Sleep Wake Disorders - physiopathology; Sleep Wake Disorders - psychology
• ISSN: 0341-2040; 1432-1750
• DOI: 10.1007/s00408-010-9277-9

Pulmonary hypertension is a disabling disease characterized by progressive functional worsening, right heart failure, and death. Although pulmonary hypertension has been associated with poor quality of life, sleep quality has not been investigated in pulmonary hypertension patients. This was a cross-sectional study in which patients (N = 40) were asked to complete standardized questionnaires to assess sleep quality [using Pittsburgh Sleep Quality Index (PSQI)], insomnia, sleepiness, dyspnea, depression, restless leg syndrome, and quality of life [using Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR)] during routine office visits. Baseline hemodynamics, pulmonary function tests, exercise capacity, and transthoracic echocardiogram were analyzed. Pulmonary hypertension functional class was World Health Organization class II [20 (50%)], III [18 (45%)], and IV [2 (5%)], and 29 (72.5%) had poor sleep quality. PSQI score was associated with CAMPHOR symptoms score (R = 0.61, P < 0.001), CAMPHOR activities score (R = 0.38, P = 0.016), CAMPHOR quality-of-life score (R = 0.45, P = 0.004), depression (R = 0.42, P = 0.007), and dyspnea (R = 0.36, P = 0.02). Sleep quality was not associated with age, gender, other comorbidities, pulmonary hypertension etiology, baseline hemodynamics, pulmonary function testing, echocardiographic parameters, or exercise capacity. Poor sleep quality is common in patients with pulmonary hypertension and correlates with depression, dyspnea, and poor quality of life. Improving sleep quality in patients with pulmonary hypertension may improve quality of life.