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SLEEP QUALITY AND CARDIOPULMONARY FUNCTIONAL CAPACITY IN OUTPATIENT CARDIAC REHABILITATION

Abstract

PURPOSE: Impaired sleep is common among people with cardiovascular disease and has been linked to adverse clinical outcomes, yet its relationship with functional capacity during cardiac rehabilitation (CR) remains understudied. The purpose of this study was to evaluate whether sleep quality predicted cardiopulmonary functional capacity in patients attending outpatient cardiac rehabilitation (OCR). METHODS: One hundred patients (67.3 ± 9.8 years, 68% male) participating in OCR following a recent cardiac event or diagnosis completed the study. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI) near OCR admission, with poor sleepers defined by a PSQI score >5. Cardiopulmonary functional capacity was determined by the 6-Minute Walk Test (6MWT), administered near OCR admission and again near OCR discharge (mean 11 weeks). Descriptive statistics and linear regression analyses were conducted with SPSS v29.RESULTS: The mean (± SD) total PSQI score was 8.81 (± 4.57), and 68% of the sample were categorized as poor sleepers. Patients categorized as poor sleepers trended towards lower 6MWT scores (327.00 ± 100.48 meters) than those categorized as good sleepers (366.26 ± 84.14 meters; p=0.059) at OCR admission, but not at discharge (p=0.55). Additionally, total PSQI scores predicted 6MWT performance at OCR admission (R2=0.07, B=-18.61, p=0.007), but not at discharge (p=0.61). CONCLUSIONS: Poor sleep was highly prevalent and associated with lower cardiopulmonary functional capacity at OCR admission. This association diminished at OCR discharge. While sleep quality predicted admission 6MWT scores, the proportion of variance explained by the independent variable was small (7%). It should be noted that several predictors of functional capacity were not examined, and the large majority of variance is unaccounted for. Future research should address limitations of this work, evaluate and intervene on sleep health in CR, and identify key factors to accelerate and enhance functional outcomes after a cardiac event.

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