[Sleep disorders dynamics in patients with chronic thromboembolic pulmonary hypertension after surgical treatment].

AIM: To investigate the association between various sleep disorders and changes in clinical status in patients with chronic thromboembolic pulmonary hypertension (CTEPH) before and after surgical treatment.

MATERIALS AND

METHODS

The study included 43 patients with a verified diagnosis of CTEPH hospitalized between December 2023 and February 2025. Assessment included general clinical status, echocardiography, and right heart catheterization data. Patients completed standardized questionnaires (STOP-Bang, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Insomnia Severity Index, International Restless Legs Syndrome Study Group Rating Scale) and underwent polyfunctional sleep monitoring before treatment and at least 3 months after completing a series of balloon pulmonary angioplasties or pulmonary thromboendarterectomy.

RESULTS

After surgical treatment, patients with CTEPH maintained a high prevalence of sleep apnea/hypopnea (83.8%) and nocturnal hypoxemia (74.4%), despite a significant decrease in mean pulmonary artery pressure - mPAP (p < 0.0001) and pulmonary vascular resistance - PVR (p < 0.0001). The baseline percentage of total sleep time with saturation below 90% (T90) was significantly associated with postoperative mPAP (p = 0.0289), PVR (p = 0.0050), and the six-minute walk test distance - 6MWD (p = 0.0305). A preoperative T90 > 11.0% showed 85.7% sensitivity in predicting the achievement of the target 6MWD (p = 0.0130) after treatment.

CONCLUSION

A high prevalence of sleep-disordered breathing in patients with CTEPH persists despite effective pathogenetic treatment of the underlying disease. Nocturnal hypoxemia may be considered a predictor for prescribing timely respiratory support and pulmonary arterial hypertension-specific therapy.