[Sleep-breathing disordered in stable chronic congestive heart failure].

OBJECTIVE

To determine the prevalence and effect of sleep-disordered breathing in patients with stable, optimally treated chronic congestive heart failure.

METHODS

Patients with stable, optimally treated chronic congestive heart failure were monitored by polysomnography (Polywin 1000, Respironics Inc.).

RESULTS

Patients were divided into two groups. Group I (n = 21) had a rate of apnea and hypopnea (apnea-hypopnea index) of 15 or less episodes per hour; group II (n = 15) had a rate of more than 15 episodes per hour. In group II, the rate varied from 16.8 to 78.8 episodes per hour 42.6 +/- 15.5, in which the obstructive apnea-hypopnea index was 11.1 +/- 8.4 and the central AHI was 31.5 +/- 9.6. Group II had significantly more arousals (36.8 +/- 21.3 compared with 19.4 +/- 11.2 in group I) that were directly attributable to episodes of apnea and hypopnea, lower arterial oxyhemoglobin saturation during sleep [(76.7 +/- 4.6)% compared with (86.5 +/- 2.8)%] and lower left ventricular ejection fraction [(24.2 +/- 8.8)% compared with (31.5 +/- 10.6)%].

CONCLUSIONS

The prevalence of sleep-disordered breathing (mainly periodic respiration or Cheyne-Stokes respiration with central sleep apnea) is high in patients with stable chronic congestive heart failure. The sleep-disordered breathing episodes are associated with severe nocturnal arterial blood oxyhemoglobin desaturation and excessive arousals. Severe untreated sleep-disordered breathing may affect left ventricular function and could contribute to death in patients with congestive heart failure.