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Risk factors for central and obstructive sleep apnea in 450 men and women with congestive heart failure

D D Sin1, F Fitzgerald, J D Parker

  • 1Sleep Research Laboratory of the Toronto Rehabilitation Institute, Department of Medicine, The Toronto Hospital, University of Toronto, Toronto, Ontario, Canada.

American Journal of Respiratory and Critical Care Medicine
|October 6, 1999
PubMed

Insights

This study identified key risk factors for central and obstructive sleep apnea in heart failure patients. Identifying these factors can help physicians better screen patients for sleep disorders.

Area of Science:

  • Cardiology
  • Pulmonology
  • Sleep Medicine

Background:

  • Previous studies on sleep apnea in congestive heart failure (CHF) primarily focused on men.
  • Risk factors for central sleep apnea (CSA) and obstructive sleep apnea (OSA) in a mixed-gender CHF population were not well-defined.

Purpose of the Study:

  • To investigate and characterize the risk factors for CSA and OSA in a cohort of male and female patients diagnosed with CHF.
  • To determine if specific demographic and clinical factors predict the presence of CSA or OSA in CHF patients.

Main Methods:

  • Analysis of data from 450 consecutive patients with CHF (382 male, 68 female) referred for sleep studies.
  • Identification of risk factors for CSA and OSA using logistic regression, considering variables such as gender, age, atrial fibrillation, hypocapnia, and body mass index (BMI).

Main Results:

  • For CSA, significant risk factors included male gender, atrial fibrillation, age over 60, and hypocapnia (wakefulness PCO2 < 38 mm Hg).
  • For OSA, risk factors varied by gender: in men, BMI > 35 kg/m² was the primary risk factor; in women, age > 60 was the significant factor.

Conclusions:

  • Physicians can utilize historical information and simple laboratory tests to stratify CHF patients for sleep apnea risk.
  • This risk stratification can guide the need for diagnostic polysomnography in patients with congestive heart failure.

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