In-hospital Testing for Sleep-disordered Breathing in Hospitalized Patients With Decompensated Heart Failure: Report of Prevalence and Patient Characteristics
Received 17 September 2008; received in revised form 25 April 2009; accepted 11 May 2009. published online 29 June 2009.
Abstract
Background
Sleep-disordered breathing (SDB) is present in more than 50% of ambulatory patients with chronic heart failure. The prevalence and type of SDB in hospitalized patients with acutely decompensated heart failure (ADHF) are not known.
Methods and Results
In-hospital sleep studies were performed on consecutive patients with ADHF who were not previously tested for SDB. A total of 395 consecutive patients with ADHF underwent successful sleep study recording during hospitalization. A total of 298 patients (75%, 95% CI [71–80%] had SDB; of these, 226 (57%, 95% CI [52–62]) had predominantly obstructive SDB and 72 (18%, 95% CI [14–22]) had predominantly central SDB. Only 25% (95% CI 20–29%) of patients were free of SDB. Validation polysomnography between 6 and 8 weeks after discharge on a subgroup of unselected patients with obstructive SDB revealed a 100 % positive predictive value (95% CI 94–100%) for obstructive sleep apnea (OSA).
Conclusions
Similar to stable chronic heart failure, ADHF is associated with a high prevalence of SDB. The prevalence of predominantly obstructive SDB exceeded that of predominantly central SDB in ADHF patients. The presence of obstructive SDB during hospitalization predicted a diagnosis of OSA on polysomnography.
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