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Occult sleep-disordered breathing in stable congestive heart failure
S Javaheri1, T J Parker, L Wexler
1Sleep Disorders laboratory, Veterans Affairs Medical Center, Cincinnati, OH 45220.
Annals of Internal Medicine
|April 1, 1995
Summary
Sleep-disordered breathing is common in stable heart failure patients and linked to lower oxygen levels and worse heart function. Untreated sleep apnea may worsen heart failure and survival outcomes.
Area of Science:
- Cardiology
- Sleep Medicine
- Pulmonology
Background:
- Congestive heart failure (CHF) is a chronic condition affecting millions globally.
- Sleep-disordered breathing (SDB) is increasingly recognized as a comorbidity in cardiovascular diseases.
- The relationship between SDB and stable CHF requires further investigation.
Purpose of the Study:
- To determine the prevalence of SDB in ambulatory patients with stable, optimally treated CHF.
- To assess the effects of SDB on cardiac function and nocturnal oxygenation in this population.
Main Methods:
- A prospective, longitudinal study was conducted in a Department of Veterans Affairs medical center.
- 42 eligible patients with stable CHF and left ventricular systolic dysfunction underwent polysomnography, Holter monitoring, and blood gas analysis.
- Cardiac radionuclide ventriculography and pulmonary, renal, and thyroid function tests were also performed.
Main Results:
- 45% of patients had severe SDB (apnea-hypopnea index > 20/hour).
- Severe SDB was associated with more arousals, prolonged nocturnal hypoxemia, lower ejection fraction, and increased ventricular arrhythmias.
- Left ventricular systolic dysfunction was an independent risk factor for SDB in CHF patients.
Conclusions:
- Severe SDB is highly prevalent in stable, treated CHF patients.
- SDB is linked to nocturnal oxygen desaturation and arousals, potentially worsening left ventricular function.
- Untreated SDB may contribute to adverse outcomes in CHF, necessitating further survival studies.
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