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Increased mortality risk in congestive heart failure patients with comorbid sleep apnoea: 10-year follow up

J P Bakker1, A J Campbell, A M Neill

  • 1WellSleep Sleep Investigation Centre, Department of Medicine, University of Otago, Wellington, New Zealand. jessie.bakker@otago.ac.nz

Internal Medicine Journal
|November 20, 2012
PubMed

Insights

Congestive heart failure patients with central sleep apnoea had significantly worse survival over 10 years. This highlights central sleep apnoea as a critical factor impacting mortality in heart failure patients.

Area of Science:

  • Cardiology
  • Sleep Medicine
  • Clinical Research

Background:

  • Congestive heart failure (CHF) is a major cause of mortality.
  • Sleep apnoea, both central and obstructive, is prevalent in CHF patients.
  • The differential impact of sleep apnoea types on CHF survival is not fully understood.

Purpose of the Study:

  • To determine 10-year mortality rates in a CHF cohort.
  • To compare survival outcomes between CHF patients with central sleep apnoea (CSA), obstructive sleep apnoea (OSA), and neither (controls).

Main Methods:

  • Prospective 10-year follow-up study of a congestive heart failure cohort.
  • Comparison of survival curves and mean survival times between patient groups: CHF only, CHF with CSA, and CHF with OSA.
  • Statistical analysis to determine significance of survival differences.

Main Results:

  • Patients with CHF and central sleep apnoea exhibited significantly reduced survival.
  • Mean survival time was 3.8 years shorter for CHF/CSA patients compared to CHF/OSA patients (P=0.005).
  • Mean survival time was 4.0 years shorter for CHF/CSA patients compared to CHF-only controls (P=0.01).

Conclusions:

  • Central sleep apnoea significantly worsens survival in patients with congestive heart failure.
  • Central sleep apnoea is associated with a greater mortality detriment than obstructive sleep apnoea in CHF.
  • Identifying and managing central sleep apnoea may be crucial for improving outcomes in heart failure patients.

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