Polysomnographic characteristics of patients with heart failure combined with sleep apnea: A systematic review and meta-analysis.

AIMS: Objective sleep parameters in patients with HF and their comorbidity with sleep-disordered breathing (SDB) are not fully understood. We aimed to investigate the polysomnography-measured sleep characteristics in HF patients using a systematic review and meta-analysis.

METHODS

PubMed, Embase, and Web of Science databases were searched for studies on PSG in HF patients. Meta-analyses were conducted to compare PSG parameters between HF patients and Non-HF, HF patients with and without SDB, HF patients with different types of SDB, and HF patients before and after SDB treatments.

RESULTS

HF patients showed decreased sleep efficiency (MD = -7.5 %, 95 %CI: [-10.8 %, -4.1 %], P < 0.001) and reduced slow wave sleep (MD = -3.2 %, 95 %CI: [-5.7 %, -0.7 %], P = 0.013) compared with those without HF. With comorbid SDB, HF patients experienced further decreases in sleep efficiency and total sleep time, and disruptions in sleep architecture, including decreased rapid-eye-movement sleep (MD = -3.4 %, 95 %CI: [-6.2 %, -0.5 %], P = 0.020) and SWS (MD = -3.1 %, 95 %CI: [-4.1 %, -2.1 %], P < 0.001).

CONCLUSIONS

HF patients showed poorer sleep continuity and less restorative sleep. Additionally, SDB was associated with poor objective sleep architecture in HF patients, indicated by a decrease in the percentage of deep sleep and an increase in sleep fragmentation. SDB treatments, such as adaptive servo-ventilation (ASV) and continuous positive airway pressure (CPAP), were associated with improved sleep quality and quantity in HF patients with SDB.