Sleep apnea in 81 ambulatory male patients with stable heart failure : Types and their prevalences, consequences, and presentations

• Published in: Circulation (New York, N.Y.) Vol. 97; no. 21; pp. 2154 - 2159
• Main Authors: JAVAHERI, S, PARKER, T. J, LIMING, J. D, CORBETT, W. S, NISHIYAMA, H, WEXLER, L, ROSELLE, G. A
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 02.06.1998; American Heart Association, Inc
• Subjects: Arrhythmias, Cardiac - etiology; Biological and medical sciences; Cardiology. Vascular system; Heart; Heart Failure - complications; Heart Failure - physiopathology; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Humans; Male; Medical sciences; Oxyhemoglobins - metabolism; Prevalence; Prospective Studies; Respiration; Sleep Apnea Syndromes - epidemiology; Sleep Apnea Syndromes - etiology; Human; Heart failure; Sleep apnea syndrome; Oxygen; Association; Arrhythmia; Respiratory disease; Heart disease; Cardiovascular disease; Artery; Desaturation
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/01.CIR.97.21.2154

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. 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. 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.