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From the Sleep Disorders Laboratory, Department of Veterans Affairs
Medical Center, and the Department of Medicine, University of Cincinnati
College of Medicine, Cincinnati, Ohio.
Background—Heart failure is a highly
prevalent disorder that continues to be associated with repeated
hospitalizations, high morbidity, and high mortality. Sleep-related
breathing disorders with repetitive episodes of asphyxia may adversely
affect heart function. The main aims of this study were to determine
the prevalence, consequences, and differences in various sleep-related
breathing disorders in ambulatory male patients with stable heart
failure.
Methods and Results—This article reports the results of a
prospective study of 81 of 92 eligible patients with heart failure and
a left ventricular ejection fraction <45%. There were 40
patients without (hourly rate of apnea/hypopnea, 4±4; group 1) and 41
patients with (51% of all patients; hourly rate of apnea/hypopnea,
44±19; group 2) sleep apnea. Sleep disruption and arterial
oxyhemoglobin desaturation were significantly more severe and the
prevalence of atrial fibrillation (22% versus 5%) and
ventricular arrhythmias were greater in group 2 than in
group 1. Forty percent of all patients had central sleep apnea, and
11% had obstructive sleep apnea. The latter patients had significantly
greater mean body weight (112±30 versus 75±16 kg) and prevalence of
habitual snoring (78% versus 28%). However, the hourly rate of
episodes of apnea and hypopnea (36±10 versus 47±21), episodes of
arousal (20±14 versus 23±11), and desaturation (lowest saturation,
72±11% versus 78±12%) were similar in patients with these different
types of apnea.
Conclusions—Fifty-one percent of male patients with stable heart
failure suffer from sleep-related breathing disorders: 40% from
central and 11% from obstructive sleep apnea. Both obstructive and
central types of sleep apnea result in sleep disruption and
arterial oxyhemoglobin desaturation. Patients with sleep
apnea have a high prevalence of atrial fibrillation and
ventricular arrhythmias.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Sleep Apnea in 81 Ambulatory Male Patients With Stable Heart Failure
Types and Their Prevalences, Consequences, and Presentations
Key Words: lung • pulmonary heart disease • oxygen • arrhythmia
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L. S. Doherty, J. L. Kiely, V. Swan, and W. T. McNicholas Long-term Effects of Nasal Continuous Positive Airway Pressure Therapy on Cardiovascular Outcomes in Sleep Apnea Syndrome Chest, June 1, 2005; 127(6): 2076 - 2084. [Abstract] [Full Text] [PDF]
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E. Skobel, C. Norra, A. Sinha, C. Breuer, P. Hanrath, and C. Stellbrink Impact of sleep-related breathing disorders on health-related quality of life in patients with chronic heart failure Eur J Heart Fail, June 1, 2005; 7(4): 505 - 511. [Abstract] [Full Text] [PDF]
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C. Sahlin, E. Svanborg, H. Stenlund, and K. A. Franklin Cheyne-Stokes respiration and supine dependency Eur. Respir. J., May 1, 2005; 25(5): 829 - 833. [Abstract] [Full Text] [PDF]
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F. Series, R. J. Kimoff, D. Morrison, M. H. Leblanc, M. Smilovitch, J. Howlett, A. G. Logan, J. S. Floras, and T. D. Bradley Prospective Evaluation of Nocturnal Oximetry for Detection of Sleep-Related Breathing Disturbances in Patients With Chronic Heart Failure Chest, May 1, 2005; 127(5): 1507 - 1514. [Abstract] [Full Text] [PDF]
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C. Carmona-Bernal, E. Quintana-Gallego, M. Villa-Gil, A. Sanchez-Armengol, A. Martinez-Martinez, and F. Capote Brain Natriuretic Peptide in Patients With Congestive Heart Failure and Central Sleep Apnea Chest, May 1, 2005; 127(5): 1667 - 1673. [Abstract] [Full Text] [PDF]
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C. Nopmaneejumruslers, Y. Kaneko, V. Hajek, V. Zivanovic, and T. D. Bradley Cheyne-Stokes Respiration in Stroke: Relationship to Hypocapnia and Occult Cardiac Dysfunction Am. J. Respir. Crit. Care Med., May 1, 2005; 171(9): 1048 - 1052. [Abstract] [Full Text] [PDF]
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S. Javaheri, K. F. Almoosa, K. Saleh, and C. L. Mendenhall Hypocapnia Is Not a Predictor of Central Sleep Apnea in Patients with Cirrhosis Am. J. Respir. Crit. Care Med., April 15, 2005; 171(8): 908 - 911. [Abstract] [Full Text] [PDF]
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M. Arzt, M. Schulz, R. Wensel, S. Montalvan, F. C. Blumberg, G. A. J. Riegger, and M. Pfeifer Nocturnal Continuous Positive Airway Pressure Improves Ventilatory Efficiency During Exercise in Patients With Chronic Heart Failure Chest, March 1, 2005; 127(3): 794 - 802. [Abstract] [Full Text] [PDF]
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C. Scharf, Y. K. Cho, K. E. Bloch, C. Brunckhorst, F. Duru, K. Balaban, N. Foldvary, L. Liu, R. C. Burgess, R. Candinas, et al. Diagnosis of Sleep-Related Breathing Disorders by Visual Analysis of Transthoracic Impedance Signals in Pacemakers Circulation, October 26, 2004; 110(17): 2562 - 2567. [Abstract] [Full Text] [PDF]
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E. Quintana-Gallego, M. Villa-Gil, C. Carmona-Bernal, G. Botebol-Benhamou, A. Martinez-Martinez, A. Sanchez-Armengol, J. Polo-Padillo, and F. Capote Home respiratory polygraphy for diagnosis of sleep-disordered breathing in heart failure Eur. Respir. J., September 1, 2004; 24(3): 443 - 448. [Abstract] [Full Text] [PDF]
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J. M. Parish and V. K. Somers Obstructive Sleep Apnea and Cardiovascular Disease Mayo Clin. Proc., August 1, 2004; 79(8): 1036 - 1046. [Abstract] [PDF]
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A. S. Gami, G. Pressman, S. M. Caples, R. Kanagala, J. J. Gard, D. E. Davison, J. F. Malouf, N. M. Ammash, P. A. Friedman, and V. K. Somers Association of Atrial Fibrillation and Obstructive Sleep Apnea Circulation, July 27, 2004; 110(4): 364 - 367. [Abstract] [Full Text] [PDF]
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H.F. Becker Bigger numbers needed! Eur. Respir. J., May 1, 2004; 23(5): 659 - 660. [Full Text] [PDF]
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T. Roebuck, P. Solin, D.M. Kaye, P. Bergin, M. Bailey, and M.T. Naughton Increased long-term mortality in heart failure due to sleep apnoea is not yet proven Eur. Respir. J., May 1, 2004; 23(5): 735 - 740. [Abstract] [Full Text] [PDF]
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T. Young, J. Skatrud, and P. E. Peppard Risk Factors for Obstructive Sleep Apnea in Adults JAMA, April 28, 2004; 291(16): 2013 - 2016. [Full Text] [PDF]
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L J Gula, A D Krahn, A C Skanes, R Yee, and G J Klein Clinical relevance of arrhythmias during sleep: guidance for clinicians Heart, March 1, 2004; 90(3): 347 - 352. [Full Text] [PDF]
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S. Javaheri, W. T. Abraham, C. Brown, H. Nishiyama, R. Giesting, and L. E. Wagoner Prevalence of obstructive sleep apnoea and periodic limb movement in 45 subjects with heart transplantation Eur. Heart J., February 1, 2004; 25(3): 260 - 266. [Abstract] [Full Text] [PDF]
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B. K. Gehlbach and E. Geppert The Pulmonary Manifestations of Left Heart Failure Chest, February 1, 2004; 125(2): 669 - 682. [Abstract] [Full Text] [PDF]
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