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[Sleep-related breathing disorders in patients with coronary heart disease]
Insights
Obstructive sleep apnoea (OSA) is more common in patients with coronary heart disease (CHD) than in the general population. Early consideration of OSA in CHD patients is crucial due to its links with nocturnal oxygen desaturation and increased blood pressure.
Area of Science:
- Cardiology
- Sleep Medicine
- Respiratory Medicine
Context:
- Obstructive sleep apnoea (OSA) is linked to arterial hypertension, independent of body weight.
- Coronary heart disease (CHD) prevalence may be influenced by OSA.
- Understanding the prevalence of OSA in CHD patients is essential for comprehensive cardiovascular care.
Purpose:
- To determine the prevalence of obstructive sleep apnoea (OSA) in patients diagnosed with coronary heart disease (CHD).
Summary:
- A study involving 50 CHD patients (diagnosed via left heart catheterization) investigated OSA prevalence.
- Apnoea index (AI) > 10/h was found in 25 patients, who were significantly older and had higher BMI.
- Polysomnography confirmed OSA in 19 of these patients, with an average AI of 17.0/h.
Impact:
- The prevalence of OSA is significantly higher in CHD patients compared to the general population.
- OSA's association with nocturnal hypoxia and hypertension may precipitate myocardial ischaemia.
- Clinicians should consider OSA screening in all diagnosed CHD patients for improved management and outcomes.
Introduction And Aim Of Study:
Obstructive sleep apnoea (OSA) favours the development of arterial hypertension independently of body-weight and may thus have an effect on coronary heart disease (CHD). This study was undertaken to determine the prevalence of OSA in patients with CHD.
Patients And Methods:
From among all patients in whom left heart catheterization with coronary angiography had provided the diagnosis of coronary heart disease 50 were randomly chosen (47 men, 3 women; mean age 61 +/- 6 years) for further investigations. During the night airway flow, heart rate, body position and arterial oxygen saturation were recorded. The patients also had to fill in a questionnaire concerning tiredness during the day and any snoring. Polysomnography was performed in all those whose apnoea index (AI) was > 10/h.
Results:
25 patients had an apnoea index of > 10/h. Eight of them also had increased tiredness during the day. The patients with an AI > 10/h were significantly older than those in whom it was < or = 10/h (63.1 +/- 3.5 vs 58.4 +/- 7.2 years; P < 0.002) and also had a higher body-mass index (27.8 +/- 4.2 vs 25.7 +/- 3.0 kg/m2; P < 0.05). Polysomnography, done in the sleep laboratory, in 19 of the 25 patients with an AI > 10/h registered an average AI of 17.0 +/- 10.9 per hour sleep; in seven patients it was > 20/h.
Conclusions:
The prevalence of obstructive sleep apnoea (OSA) is higher in patients with coronary heart disease (CHD) than in the healthy population. As OSA associated with a marked fall in nocturnal blood oxygen saturation and a rise in blood pressure may cause myocardial ischaemia, OSA should also always be considered when CHD is diagnosed.