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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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