Sleep conditions and quality of life among patients with ischemic heart disease after elective percutaneous coronary intervention

In Japan, percutaneous coronary intervention (PCI) is a major therapeutic intervention for ischemic heart disease (IHD). Previous studies suggested that an association of the risk of IHD caused by sleep duration was related to factors closely associated with daily activities. However, in Japan, there is no study about this relationship objectively measured using the actigraphy in patients with IHD. Moreover, there is little reported data about sleep condition and early outcomes of patient’s Health-Related Quality of Life (QOL) after PCI. This study determines the correlations between sleep conditions and QOL (measured by SF36 version 2) of 25 patients with IHD who underwent elective PCI. Data were collected seven days after PCI using night-sleep condition. Using Spearman’s rank test, the results revealed positive correlation between vitality score and longest sleep duration (ρ = 0.43, p = 0.031): social functioning (SF) score and duration of night-time sleep (ρ = 0.42, p = 0.037);total sleep duration (ρ = 0.45, p = 0.026), and longest sleep duration (ρ = 0.44, p = 0.024);mental health score and longest sleep duration (ρ = 0.54, p = 0.006). However, negative correlation was found between physical functioning score and arousal during sleep (ρ = -0.44, p = 0.027). Sleep condition was significantly correlated with QOL. In particular, SF score was positively related to night-time sleep. This seems to indicate that SF score might be related to night-time sleep condition. Moreover, the longest sleep durations were correlated with the mental component summary. The results of the study suggest that not only the length of whole sleep durations leads to better QOL, but also the increase the amount of uninterrupted sleep.

Daily Activities and Sleep Durations of Patients with Ischemic Heart Disease Who Were Discharged to Their Homes after Elective Percutaneous Coronary Intervention

The purpose of this study was to examine the relationship between daily activities and sleep durations for patients following elective percutaneous coronary intervention (ePCI) and diagnosed with ischemic heart disease (IHD) after discharge to their homes. The actigraph data were used to collect data from twenty five patients. The duration of night-time sleep (minutes from the start to end of night-time) and actual night-time sleep duration (total sleep duration excluding wake-up durations of night-time) on the seventh day after discharge were divided into three groups;less than 360, 360 to 480, and more than 480 minutes (short, optimal and long respectively). Subsequently, among the three groups of patients, the data were analyzed by Kruskal Wallis H-test with multiple comparison procedures using the Scheffé-test in order to compare differences in daytime activity items at seven days after discharge from the hospital. Total daytime nap duration (p p p p < 0.05). However, the duration of night-time sleep and daytime activity did not significantly differ. If actual night-time sleep duration is improved from 360 to 480 minutes, daytime nap could potentially be decreased. Determining objective sleep conditions for patients and treating sleep disorders may improve overall patient health, facilitating appropriate sleep and wake rhythms.

The relationship between sleep condition and autonomic nervous function in women in their 70s with type 2 diabetes mellitus

The aim of this study was to determine the relationship between sleep condition and autonomic nervous function of women in their 70s with type 2 diabetes mellitus by analyzing the activity counts (AC) on actigraphs and heart rate variability (HRV). Ten healthy women in their 30s to 40s as control and four women patients with type 2 diabetes in their 70s wore the electrocardiograph and an actigraph for 24 hours while keeping a diary of activities, including their sleep and food intake. The Pittsburgh Sleep Quality Index was used to assess subjective sleep conditions. The subjective sleeping results were significantly correlated with those measured by the AC and HRV. However, AC and HRV correlation pattern showed different activity in the patients with type 2 diabetes mellitus. The quality of sleep of those with chronic diabetes was not good even if their HbA1c was well controlled. Furthermore, their automatic nervous function was different from the control group. The sleeping hours of patients with type 2 diabetes were shorter or longer than those of healthy women. Ultimately, this study maintains that it is important to examine automatic nervous functions using objective examination index during the early stage of diabetes mellitus.

Changes before and after improvement of subjective sleep state of a man diagnosed with pre-diabetes and sleep disorder

The purpose of this case study was to examine the changes before and after improvements of the subjective sleep status of Mr A, a 40-year-old man diagnosed with pre-diabetes and a sleep disorder. Data were collected using a Holter monitor for 24 hours a day for 3 days to assess autonomic nervous activity by recording bed-time and waking time activity (activity counts: ACs). Mr. A kept a diary of activities and completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire. The study revealed that subjective sleeping hours correlated almost precisely with those measured by the actigraph and as described in the diary. Both the parasympathetic and sympathetic nervous system activities were imbalanced. However, no correlation was observed between the ACs and autonomic nervous activity. Subjective sleep state according to the PSQI score improved remarkably by dietary and exercise therapy from 13 to 3 points, after six months, with corresponding high level sleep satisfaction level. Significant correlations were observed between ACs and high-frequency spectral power of R-R intervals, and between ACs and the low-frequency/high frequency ratio of spectral power of R-R intervals. Although Mr. A’s sleep satisfaction level has improved, the autonomic nervous system activity remained different from that of healthy people.