A retrospective study of sleep breathing disorder therapies and treatment attitudes among adult heart failure patients
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The purpose of this study was to determine if the use of positive airway pressure [PAP] for sleep breathing disorder [SBD] in a heart failure population would improve quality of life [QOL] and cardiovascular endurance as compared to the use of nocturnal oxygen therapy, and to examine health attitudes related to compliance with recommended treatment for SBD. A retrospective chart review was completed to determine models and variables for predicting improvements in QOL and cardiovascular endurance. The Minnesota Living with Heart Failure® Questionnaire [MLHFQ] was used to assess perceived QOL and the Six Minute Walk Test [6MWT] was used to evaluate cardiovascular endurance. Measures were taken at baseline and six months after treatment with PAP or nocturnal oxygen therapy. An analysis to determine the relationship between the NYHA classification of heart failure and participant QOL was also conducted. Additionally, demographic data was collected to examine the population and qualitative analysis was used to study health attitudes related to SBD treatment modalities chosen. Two statistically significant models were found to be predictive in estimating QOL and cardiovascular endurance six months after treatment for SBD (p<.05, p<.01). Although both groups improved in distance walked and perceived QOL, individuals treated with PAP had statistically significant increases in distance walked (p<.01) when compared to the nocturnal oxygen therapy group. There was no statistically significant relationship between NYHA classification of heart failure and participant QOL (p=.903). Men were more likely to comply with recommended PAP treatment and themes associated with refusal of PAP treatment included the inconvenience associated with an overnight sleep study, perception of being too old, complications related comorbidities, and cost. Findings contribute to evidence of PAP as the recommended treatment for SBD. Descriptive and inferential findings can aid the health educator and healthcare provider in identifying treatment options and barriers associated with compliance for the patient with combined SBD and heart failure.