PMID- 32588662
OWN - NLM
STAT- MEDLINE
DCOM- 20210728
LR  - 20210919
IS  - 1525-6073 (Electronic)
IS  - 0742-0528 (Print)
IS  - 0742-0528 (Linking)
VI  - 37
IP  - 8
DP  - 2020 Aug
TI  - Rest-activity rhythms, daytime symptoms, and functional performance among people 
      with heart failure.
PG  - 1223-1234
LID - 10.1080/07420528.2020.1779280 [doi]
AB  - Sleep disturbance and decreased daytime activity are well-described among people 
      with chronic heart failure (HF) who suffer from disabling daytime symptoms and 
      poor function. Alterations in the circadian rhythmicity of rest-activity may also 
      be associated with these outcomes. However, little is known about the 
      associations between rest-activity rhythms (RARS), symptoms, and functional 
      performance or the extent to which they are explained by sleep characteristics 
      among people with HF. The purpose of this study is to evaluate parametric and 
      non-parametric circadian characteristics of RARs and the associations between 
      these variables, daytime symptoms, and functional performance among patients with 
      stable heart failure (HF). We recruited adults with stable HF from HF disease 
      management programs. Participants wore wrist actigraphs for 3 d, completed one 
      night of unattended polysomnography and the Six Minute Walk Test, and reported 
      daytime symptoms and physical function. We performed cosinor, non-parametric, and 
      spectral analyses to evaluate the rest-activity rhythms and computed bivariate 
      correlations between the rest-activity rhythm, demographics, daytime symptoms, 
      and functional performance. We conducted multiple regression analysis to examine 
      how RARs contribute to daytime symptoms and functional performance after 
      controlling for insomnia and covariates. The sample included 135 participants 
      [Mean age = 60.6 (16.1) y, n = 88 (65.2%) male]. Older age, greater comorbidity, 
      and poorer New York Heart Association (NYHA) Class, and more EEG arousals were 
      associated with greater intra-daily variability of the RAR. More robust 
      rhythmicity represented by the circadian quotient was associated with better NYHA 
      class and less sleep fragmentation. A higher circadian quotient was significantly 
      associated with lower fatigue, depression, and sleepiness, and better functional 
      performance after controlling for insomnia and clinical and demographic 
      characteristics. Circadian parameters of rest-activity are associated with 
      symptoms and functional performance among people with HF independent of insomnia 
      or sleep disordered breathing. Interventions targeted at improving the stability 
      and strength of rest-activity rhythms may improve symptom and functional outcomes 
      for these patients.
FAU - Jeon, Sangchoon
AU  - Jeon S
AUID- ORCID: 0000-0003-2855-2053
AD  - Yale School of Nursing , West Haven, Connecticut, USA.
FAU - Conley, Samantha
AU  - Conley S
AUID- ORCID: 0000-0002-4501-5244
AD  - Yale School of Nursing , West Haven, Connecticut, USA.
FAU - Redeker, Nancy S
AU  - Redeker NS
AUID- ORCID: 0000-0001-7817-2708
AD  - Yale School of Nursing , West Haven, Connecticut, USA.
LA  - eng
GR  - P20 NR014126/NR/NINR NIH HHS/United States
GR  - R01 NR008022/NR/NINR NIH HHS/United States
GR  - R01 NR016191/NR/NINR NIH HHS/United States
GR  - UL1 TR001863/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20200626
PL  - England
TA  - Chronobiol Int
JT  - Chronobiology international
JID - 8501362
SB  - IM
MH  - Adult
MH  - Aged
MH  - Circadian Rhythm
MH  - *Heart Failure
MH  - Humans
MH  - Male
MH  - Physical Functional Performance
MH  - Polysomnography
MH  - Sleep
MH  - *Sleep Wake Disorders
PMC - PMC7529895
MID - NIHMS1603208
OTO - NOTNLM
OT  - Circadian rest-activity rhythm
OT  - cosinor analysis
OT  - fatigue
OT  - heart failure
OT  - insomnia
OT  - sleep
COIS- Disclosure of interest: Nancy Redeker (presence of financial support and absence 
      of conflict of interest), Sangchoon Jeon (presence of financial support and 
      absence of conflict of interest), Samantha Conley (presence of financial support 
      and absence of conflict of interest)
EDAT- 2020/06/27 06:00
MHDA- 2021/07/29 06:00
PMCR- 2021/08/01
CRDT- 2020/06/27 06:00
PHST- 2020/06/27 06:00 [pubmed]
PHST- 2021/07/29 06:00 [medline]
PHST- 2020/06/27 06:00 [entrez]
PHST- 2021/08/01 00:00 [pmc-release]
AID - 10.1080/07420528.2020.1779280 [doi]
PST - ppublish
SO  - Chronobiol Int. 2020 Aug;37(8):1223-1234. doi: 10.1080/07420528.2020.1779280. 
      Epub 2020 Jun 26.