Highlights
- •There is a high prevalence of “poor sleep” across sleep health domains in HFpEF (16–78%).
- •Poorer sleep health was associated with greater BMI and intermuscular thigh fat in HFpEF patients.
- •Research is needed to determine whether sleep is a potential candidate for individual or adjunctive interventions to address obesity in HFpEF.
Abstract
Background
There are bi-directional relationships between sleep disturbances and obesity, both
of which are prevalent in patients with heart failure with preserved ejection fraction
(HFpEF). However, little is known about the sleep-obesity association in HFpEF.
Objectives
To determine associations of multidimensional sleep health, night movement, sleep
fragmentation, and sleep-disordered breathing (SDB) risk with overall and regional
adiposity in HFpEF patients.
Methods
Men and women with HFpEF (n = 49) were assessed via 14-day actigraphy, Pittsburgh Sleep Quality Index, and Epworth
Sleepiness Scale to derive multidimensional sleep health. SDB risk was assessed via
Berlin Questionnaire. Body composition was measured using anthropometry; MRI quantification
of epicardial, abdominal, liver, and thigh adipose tissue was performed in a subsample
(n = 22). Spearman correlation (rs) and linear regression analyses (β coefficient) were used to estimate bivariate and age-adjusted associations.
Results
Multidimensional sleep health was inversely associated with BMI (rs = -0.50, p < .001; unadjusted: β = -4.00, 95%CI: -5.87, -2.13; age-adjusted: β = -2.48, 95%CI: -4.65, -0.30), thigh subcutaneous adipose tissue (rs = -0.50, p = .018; unadjusted: β = -36.95, 95%CI: -67.31, -6.59), and thigh intermuscular fat (age-adjusted: β = -0.24, 95%CI: -0.48, -0.01). Night movement and sleep fragmentation were associated
with greater intermuscular thigh and lower liver fat. High SDB risk was associated
with a higher visceral-to-subcutaneous ratio of abdominal adiposity and lower thigh
adiposity.
Conclusions
Adverse multidimensional sleep health is associated with higher adiposity measures
in HFpEF patients. Further studies are needed to determine whether intervening on
sleep could ameliorate excess adiposity or whether weight loss could improve sleep
quality in HFpEF.
Keywords
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Article info
Publication history
Published online: December 11, 2022
Accepted:
December 4,
2022
Received in revised form:
October 24,
2022
Received:
May 25,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
