Jan Albers

6-month CPAP, treatment in a young male patient with severe obstructive sleep apnoea syndrome - : A case study from the couple´s perspective

Background: Obstructive sleep apnoea syndrome (OSAS) is independently associated with an increased risk for hypertension and cardiovascular disease. Continuous positive airway pressure (CPAP) can reduce mortality and morbidity, but low compliance rates are seen. Aim: To explore and describe the experiences of CPAP-treatment in a young male patient with severe OSAS during a 6-month period from the couples perspective. Methods and the case: A single case study with a phenomenographic approach was employed. Diagnostic procedures of OSAS and initiation of treatment with Auto-CPAP, humidifier and a nasal mask were performed during 4 visits. Conceptions were collected at 4 different occasions during the 6-month period (before, and 2 weeks, 3 months, and 6 months after treatment initiation) by means of interviews with a 33-year old male patient and his female partner. Findings: Totally 17 different structural aspects were found to fluctuate during the 6-month period in relation to; influence of stressors, social reactions and adaptation to increase compliance. Conclusion: An increased knowledge about the influence of stressors, the social reactions, and the adaptation can help healthcare personnel to identify and better understand concerns of other patients and spouses during different time phases of the initial 6-month period of CPAP-treatment.

FP39 Difference in Insomnia Symptoms, Daytime Sleepiness, Fatigue and Global Perceived Health between Hypertensive Patients with or without Risk of Obstructive Sleep Apnoea in a Primary Care Setting:

Purpose: Recovery from a cardiovascular (CV) event occurs between diagnosis and subsequent physical/emotional healing. A patients’ spouse is thought to be key in recovery. In CV patients and spouses, emotional responses, social support, and lack of knowledge regarding self-care are theoretically predictive of physical/emotional healing. The purpose of this study is to measure these three factors at 6 weeks after CV event discharge, and to compare these factors in older patients and their spouses. Methods: This is an exploratory descriptive study that enrolled older adults (> 65 years) and their spouses with 3 common CV events: heart attack (MI), surgery (CABS) and percutaneous coronary intervention (PCI). Dyads completed the Profile of Mood States (POMS), a measure of psychological distress, the Lubben Social Network Scale (SNS), a measure of social networks, and the Moser Needs Assessment (MNA), a measure of self-care need importance and whether need was met. Results: There were 161-paired subjects that were sent questionnaires at 6 weeks, and 88 patients (55% response) and 77 spouses responded (48% response). Mean age for patient was 72.9 years; 85 males/16 females who had a mean length of stay of 1.8 days for PCI, 12.7 days for CABG, and 6.7 days for MI/PCI. There was a statistically significant difference between patients and spouses on the anxiety subscale of the POMS (3.3+2.9 (pt) vs 4.6+4.3 (spouse), t= -2.18, p<0.031). The SNS demonstrated a functional network of family/friends. Patients and spouses ranked the need for honest explanations, hope, specific facts and instructions about heart disease similarly. Spouses rated honest explanations (t= -2.0; p<0.044), hope (t= -2.7, p<0.007) and specific facts as more important than patients (t= -2.59, p<0.010). Additionally, spouses wanted to feel comfortable leaving patient during the early recovery (t= -2.5, p<0.012). There were 10 spouse informational needs that were not met, 5 emotional and 5 knowledge needs. Conclusions: Data identify unmet higher anxiety levels in spouses and a number of unique needs that were unmet during the patient’s recovery. These data indicate that spouses may require interventions during recovery.

1383 Effects of obstructive sleep apnoea syndrome before treatment initiation - A case study from the spouse perspective

Sciences Linköping University, Linköping, Sweden Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden School of Human Sciences, University of Kalmar, Kalmar, Sweden Department of Cardiology, Linköping University Hospital, Linköping, Sweden Department of Internal Medicine, County Hospital Ryhov, Jonkoping, Sweden Department of Neuroscience and Locomotion, Faculty of Health Sciences Linköping University, Linköping, Sweden ⁎ Corresponding author. Department of Neurophysiology, University Hospital, S-581 85 Linköping, Sweden. Tel.: +46 13 222534. Email: andbr@imv.liu.se.

1324: Signs and consequences of obstructive sleep apnea

Background: Patients with chronic heart failure (CHF) have a reduced health-related quality of life (HRQOL) especially if sleep disturbances are involved. Depressive symptoms (DS) has also been described as a prevalent problem in patients with CHF, but few if any studies have focused the relationship to sleep, daytime sleepiness and HRQOL. Aim: To describe the prevalence of self-assessed DS and the relation to sleep, daytime sleepiness and HRQOL in men and women with CHF. Design and sample: Cross sectional design including 212 (129 male and 83 female) patients with CHF, NYHA classification II–IV. Measurements: Self-assessed sleep difficulties (Uppsala Sleep Inventory-CHF), daytime sleepiness (Epworth Sleepiness Scale), and HRQOL (36-Item Short Form Health Survey and Minnesota Living with Heart Failure questionnaire), depressive sympthomatology (MH-5 from the SF-36; cut of <52 indicating depressive symptoms). Findings: A total of 19% of the male and 24% of the female patients suffered from DS. Both male and female patients suffering from DS showed significantly shorter total sleep time, more problems with difficulties initiating and maintaining sleep ( p <0.01), as well as early morning awakenings ( p <0.05) compared to patients without DS. A total of 55% of the patients with DS woke up three times or more, and 11% were awake more than three hours during the night. DS correlated significantly and positively with anxiety during the night (r =0.30, p =0.01), dyspnoea during the night (r =0.26, p =0.01), and a feeling of tachycardia during the night (r =0.33, p =0.01). Almost all dimensions of the SF-36, as well as total and subscale scores for the disease-specific MLWHF showed significantly reduced HRQOL ( p <0.01–0.001) for male and female patients suffering from DS compared to those without DS. Conclusion: Men and women with CHF who suffer from depressive symptoms have a reduced HRQOL, more problems with difficulties initiating and maintaining sleep, as well as early morning awakenings compared to CHF patients without DS.