Impact of nocturnal oxygen saturation on sleep quality and exercise performance in adult Fontan patients
- 1Exercise Physiology Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- 2Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland
- 3Exercise Physiology Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland; Corresponding author. ETH Zurich, Exercise Physiology Lab, Department of Health Sciences and Technology, Gloriastrasse 37/39, 8092, Zurich, Switzerland.
Abstract
Introduction: A decreased peripheral oxygen saturation (SpO 2 ) is common in Fontan patients. We aimed to determine whether these patients experience greater nocturnal desaturation (ΔSpO 2,noct ), and to which extent this may impact sleep quality and exercise performance, compared to healthy controls. Methods: 16 adult Fontan patients and 16 healthy, individually matched controls completed questionnaires on quality of life, sleep quality, and daytime sleepiness, performed measurements of lung function and diffusion capacity (DLCO), and cycled in a cardiopulmonary exercise test to volitional exhaustion. Sleep quality was assessed with a wrist-worn actigraph and nocturnal SpO 2 was measured with a pulse oximeter during six nights. Results: Fontan patients experienced greater ΔSpO 2,noct (−3.4 ± 0.8%-points, n = 14) compared to their controls (−2.5 ± 0.6%-points, n = 14, p = 0.001). In patients, ΔSpO 2,noct correlated with baseline SpO 2 , DLCO, and exercise performance. Fontan patients had a longer sleep onset latency (22.8 ± 9.6 vs. 10.8 ± 6.0 min, p < 0.001) and lower self-perceived physical functioning (91 ± 7 vs. 100 ± 0 points, p < 0.001), but similar subjective sleep quality (4.2 ± 1.5 vs. 3.4 ± 1.4 points, p = 0.121) and daytime sleepiness (6.1 ± 4.3 vs. 6.3 ± 2.8 points, p = 0.884) compared to controls. In patients, daytime sleepiness correlated with the total number of desaturation events (r = 0.74, p = 0.003). Conclusion: Indices of nocturnal SpO 2 were related to daytime sleepiness and reduced exercise performance, and may therefore be a contributing factor to exercise limitation in adult Fontan patients. Enhancing nocturnal SpO 2 may thus be a promising target to improve daytime sleepiness and exercise performance in adult Fontan patients.
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BibTeX
@article{schon2026impact,
title = {{Impact of nocturnal oxygen saturation on sleep quality and exercise performance in adult Fontan patients}},
author = {Patrick Schön and Kyle G.P.J.M. Boyle and Fernando G. Beltrami and Matthias Greutmann and Christina M. Spengler},
journal = {International Journal of Cardiology Congenital Heart Disease},
year = {2026},
month = aug,
doi = {10.1016/j.ijcchd.2026.100712},
url = {https://doi.org/10.1016/j.ijcchd.2026.100712},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Impact of nocturnal oxygen saturation on sleep quality and exercise performance in adult Fontan patients
AU - Patrick Schön
AU - Kyle G.P.J.M. Boyle
AU - Fernando G. Beltrami
AU - Matthias Greutmann
AU - Christina M. Spengler
PY - 2026
DA - 2026/08/27
JO - International Journal of Cardiology Congenital Heart Disease
DO - 10.1016/j.ijcchd.2026.100712
UR - https://doi.org/10.1016/j.ijcchd.2026.100712
AB - Introduction: A decreased peripheral oxygen saturation (SpO 2 ) is common in Fontan patients. We aimed to determine whether these patients experience greater nocturnal desaturation (ΔSpO 2,noct ), and to which extent this may impact sleep quality and exercise performance, compared to healthy controls. Methods: 16 adult Fontan patients and 16 healthy, individually matched controls completed questionnaires on quality of life, sleep quality, and daytime sleepiness, performed measurements of lung function and diffusion capacity (DLCO), and cycled in a cardiopulmonary exercise test to volitional exhaustion. Sleep quality was assessed with a wrist-worn actigraph and nocturnal SpO 2 was measured with a pulse oximeter during six nights. Results: Fontan patients experienced greater ΔSpO 2,noct (−3.4 ± 0.8%-points, n = 14) compared to their controls (−2.5 ± 0.6%-points, n = 14, p = 0.001). In patients, ΔSpO 2,noct correlated with baseline SpO 2 , DLCO, and exercise performance. Fontan patients had a longer sleep onset latency (22.8 ± 9.6 vs. 10.8 ± 6.0 min, p < 0.001) and lower self-perceived physical functioning (91 ± 7 vs. 100 ± 0 points, p < 0.001), but similar subjective sleep quality (4.2 ± 1.5 vs. 3.4 ± 1.4 points, p = 0.121) and daytime sleepiness (6.1 ± 4.3 vs. 6.3 ± 2.8 points, p = 0.884) compared to controls. In patients, daytime sleepiness correlated with the total number of desaturation events (r = 0.74, p = 0.003). Conclusion: Indices of nocturnal SpO 2 were related to daytime sleepiness and reduced exercise performance, and may therefore be a contributing factor to exercise limitation in adult Fontan patients. Enhancing nocturnal SpO 2 may thus be a promising target to improve daytime sleepiness and exercise performance in adult Fontan patients.
SN - 2666-6685
ER -