Effects of 3-month Astaxanthin Supplementation on Sleepiness, Physical Activity and Health Related Quality-of-life in Heart Failure Patients with Sleep-disordered Breathing

Background: Sleep disordered breathing (SDB) was observed in 50% of patients with heart failure (HF), and reportedly worsens clinical outcome possibly through increased oxidative stress. Astaxanthin which consist of the natural products is one of the carotenoid and antioxidative products. We planned a prospective pilot study in HF patients with SDB to investigate improvements of sleepiness, physical activity, health related quality of life (QoL) in addition to the reduction of oxidative stress level by 3-month astaxanthin supplementation. Methods: We investigated changes in their oxidative stress levels by diacron reactive oxygen metabolite (dROM) test, sleepiness by Epworth sleepiness scale (ESS), physical activity by specific activity scale, and QoL by SF-8 before and after 3-month astaxanthin supplementation. Results: Nineteen patients with HF were enrolled (mean age, 67.3 years; 16 men; mean ejection fraction, 33.6%). The dROM test reduced from 390.4 ± 82.4 U to 348.7 ± 55.8 U (P = .041). In addition, subjective sleepiness (ESS score, from 5.2 ± 5.7 to 2.0 ± 2.7, P = .008), physical activity (specific activity scale from 4.8 ± 1.2 to 6.1 ± 1.1, P = .009) and QoL (physical component summary score, from 46.1 ± 9.5 to, 50.1 ± 6.6, P = .009; and mental component summary score, from 48.5 ± 9.2 to 53.8 ± 4.8, P = .031) improved significantly. Conclusion: In this pilot study, three-month astxanthin supplementation alleviated subjective sleepiness, and improved physical activity and QoL in addition to the reduction of oxidative stress levels in HF patients with SDB.