Michael Le Grande

Michael Le Grande 

Senior Research Fellow

Honorary Senior Fellow, Faculty of Health, Deakin University

My key concerns include:

Sleep apnea in heart disease patients: Sleep apnea is a sleep disorder characterised by pauses in breathing during sleep. Individuals with sleep apnea are rarely aware of having difficulty breathing, even upon awakening. It is known that patients recovering from heart disease may be susceptible to this disorder. Recent studies indicate that sleep apnea is a far bigger problem in heart disease patients than originally thought. Our research indicates that almost three-quarters of patients may have a sleep disorder in the early weeks after their heart attack. This may be partly understandable given the physical effects of surgery and medication on these patients early in treatment. Our research indicates, however, that sleep disturbances persist well after the treatment phase with 60% of patients still suffering from apnea a year after their heart attack. Many patients are completely unaware that sleep apnea may be contributing to their feelings of fatigue and lack of energy. Further, our results demonstrated an alarming association of sleep problems with anxiety and depression over the first year of recovery. It is known that depression can hamper with rehabilitation of the patient. For example, patients may be less inclined to stick to diets and exercise plans when they are depressed. One implication of results such as these is that it may be important to screen patients for presence of sleep apnea early on in their treatment phase. If the patient can be treated for their sleeping problems early on, it is likely that rehabilitation will be more successful and the chance of future heart attacks will be greatly reduced.

Walking as therapy for heart disease patients: Heart disease patients who are physical activity have a mortality rate one-third lower than those who are generally inactive. Unfortunately, many patients find it difficult to take part in any sort of moderate or vigorous exercise. This is the type of exercise that makes you puff and sweat. Understandably, many patients experience barriers to exercise such as fear of injury, lack of confidence in their ability, lack of facilities, lack of time, and their own frailty. Many are unaware that heart health can be improved by simply taking a walk for at least half an hour each day. In our study all heart disease patients were able to walk regularly. It is the amount and pace of walking that gradually needs to be increased over the course of recovery in order to gain maximum health benefits. At least 150 minutes per week (half an hour per day) is sufficient to reach the recommended national guidelines and help prevent future heart attacks. More than 2,000 years ago, Hippocrates said, “Walking is a man’s best medicine.” This still holds true today.

Quality of life in recovering heart disease patients: Increasingly, the goal of treatment for heart disease patients is not only to prolong life, but to relieve symptoms and improve quality of life. I want to improve patients’ lives as well as help them live longer.  Quality of life refers to the individual’s physical, emotional, and social wellbeing. In a nutshell it is the patients' own perception of their health status rather than the doctors’ assessment. Quality of life can predict the use of health services, the recurrence of heart disease events, and mortality. Our research has shown that while most heart disease patients demonstrate a gradual improvement in quality of life following their event, another group of patients struggle to return to normal levels. We found that lowers levels of cognitive functioning predicted a slower return to normal quality of life. This type of research can help clinicians and researchers identify characteristics that predict poor quality of life after discharge from hospital. This in turn can lead to valuable support for such patients. I also do the ACHH’s data management, statistical analysis and some IT support (well somebody has to do it).