TITLE:
Sleep disordered breathing in coronary heart disease patients with mild and moderate heart failure
AUTHORS:
Giedrius Varoneckas, Aurelija Podlipskyte, Audrius Alonderis, Arvydas Martinkenas
KEYWORDS:
Sleep; Sleep Apnoea; Oxygen Desaturation; Coronary Heart Disease; Heart Failure
JOURNAL NAME:
Health,
Vol.5 No.8B,
August
14,
2013
ABSTRACT:
The purpose of the
study was to investigate the relationship between sleep disordered breathing
(SDB) and degree of heart failure (HF) in patients with coronary heart disease
(CHD). A total of 3017 patients (77.4% men and 22.6% women) were included in
the study. Clinical examination and echocardiography for evaluation of HF using
NYHA functional classification and sleep polysomnography were performed. The
study demonstrated that SDB is more common in CHD patients with higher NYHA
functional class. The prevalence of central sleep apneas against obstructive
apneas was observed in patients with mild and moderate HF. The number of
central apneas was strongly related to the severity of heart failure. More
frequent appearance of central sleep apneas is predominantly due to instability
of ventilatory control systems during sleep because of impaired cardiac
function in HF patients. Sleep architecture was more disturbed in CHD
patients with higher NYHA functional class. A gradual increase of stage 1 and
wakefulness after sleep onset and a decrease of sleep stages 3-4 and REM sleep
as well as a diminution of sleep efficiency with worsening of NYHA functional
class were observed. We suggest that both SDB and disturbed sleep variables independently significantly correlate with manifestation of HF.