0212 Impact of At-Home Sleep Extension Intervention on Functional Capacity in Patients with Heart Failure: Results from SLEEP-HF Pilot Feasibility Study

Abstract Introduction Heart failure with preserved ejection fraction (HFpEF) covers more than half of all heart failure cases in the US. Poor sleep quality has been identified as a significant risk factor for HFpEF. Behavioral sleep extension interventions have shown positive health outcomes. However, it is yet to be tested in patients with HFpEF who often suffer from poor sleep quality. We hypothesize that a personalized sleep extension intervention is feasible in patients with HFpEF who habitually experience poor sleep quality and would improve functional capacity Methods Participants completed a 2-week single-arm open-label feasibility study with a 1-week run-in phase. After the run-in phase, participants who qualified received a 40-minute sleep coaching session, which combines sleep education, cognitive behavioral techniques, lifestyle coaching in addition to sleep hygiene training. Participants received an over-the-phone re-coaching session after one week and returned for the final visit after two weeks. The outcomes were assessed using actigraphy-based sleep assessment, the 6-minute walk test for functional capacity, and anthropometry. The feasibility outcomes were reported descriptively. We used a t-test to compare the differences between baseline and the end of the study Results 10 participants (80% female, 60% Black African American, mean age 71.5±9.5 years, BMI 36.5±11.6 kgm-2, 6MWD 244.3±87.7 meters) were enrolled and 9 of them completed the intervention. Total bedtime (+0.26 hours, p= 0.021), sleep time (+0.6 hours, p= 0.001), sleep efficiency (+5.7%, p=0.004) significantly increased, where wake up after sleep onset (-17.7 minutes, p=0.002), movement index (-5.3%, p=0.006), and sleep fragmentation index (-8.1, p=0.009) were reduced significantly (Figure 1A). 6-minute walk distance was significantly increased 20.14±17.7 (p=0.009) compared to baseline. Sleep extension was associated with an increase of 20.14±17.7 (p=0.009) meters 6-minute walk distance (6MWD) (Figure 1B). However, sleep efficiency (r=0.78, 95%CI: 0.2, 0.9; p=0.014) and WASO (r= -0.67, 95%CI: 0.9, 0.01; p=0.049) was associated with 6MWD but not with other sleep parameters. Conclusion Our results suggest that the sleep extension intervention is feasible and can be a viable tool to improve functional capacity in patients with HFpEF. These compelling results underscore the urgent need for further research with a larger, properly randomized sample to confirm these promising findings. Support (if any)