Multimodal brain imaging investigation of self-reported sleep quality and daytime sleepiness in older adults with heart failure

ABSTRACT

Purpose of the study: Individuals with heart failure (HF) have a high frequency of sleep problems. Patients with HF present with structural brain changes different from normal aging including reductions in brain volume, increases in white matter hyperintensity (WMH) and reduced cerebral blood flow. These structural changes in the brain may explain the pathophysiology of sleep and daytime problems. The objective of this study was to determine whether multimodal imaging data are related to self-reported sleep problems and daytime sleepiness in older adults with HF.

Methods: Participants in this study underwent magnetic resonance imaging scans on the General Electric 3.0 T Discovery MR750 to acquire WMH, cerebral blood flow and brain volume. Data on 37 stable HF patients (mean age = 68; SD = 5.75) were included.

Results: In this sample, WMH was associated with daytime sleepiness (p = 0.025). However, gray and white matter volume and cerebral blood flow were not associated with daytime sleepiness, sleep quality or insomnia.

Conclusion: Although further studies are needed to determine the relationship between WMH and sleep and daytime problems, the findings preliminarily support that increases in WMH from ischemic changes could explain increases in daytime sleepiness among people with HF.

KEYWORDS:

• Heart failure
• excessive daytime sleepiness
• sleep quality
• brain
• neuroradiology

Acknowledgments

Authors thank Sterling C. Johnson, PhD, Barbara B. Bendlin, PhD, Oliver Wieben, PhD and Jennifer M. Oh, for advices regarding MRI data acquisition and analysis.

Disclosure statement

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Nursing Research or the National Institutes of Health. The authors have indicated no financial conflicts of interest.

Additional information

Funding

This work was supported by the University of Wisconsin– Madison School of Nursing Research Fund, Sigma Theta Tau Beta-Eta at Large chapter; National Institute of Health/ National Institute of Nursing Research [grant number R00NR012773] (Brain Alterations and Cognitive Impairment in Older Adults with Heart Failure; Bratzke, PI).