Journal of Cardiac Failure
Volume 15, Issue 9 , Pages 739-746, November 2009

In-hospital Testing for Sleep-disordered Breathing in Hospitalized Patients With Decompensated Heart Failure: Report of Prevalence and Patient Characteristics

  • Rami N. Khayat, MD

      Affiliations

    • Division of Pulmonary Critical Care and Sleep, Ohio State University, Columbus, OH
    • Corresponding Author InformationCorrespondence to: Rami Khayat, MD, The Ohio State University Sleep Heart Program, 201 DHLRI, 473 West 12th Avenue, Columbus, OH 43210. Tel: (614) 247-7717; Fax: (614) 293-1496.
    • ,
  • David Jarjoura, PhD

      Affiliations

    • Center for Biostatistics and College of Public Health, Ohio State University, Columbus, OH
    • ,
  • Brian Patt, BS

      Affiliations

    • Division of Cardiovascular Medicine, Ohio State University, Columbus, OH
    • ,
  • Todd Yamokoski, RN

      Affiliations

    • Division of Cardiovascular Medicine, Ohio State University, Columbus, OH
    • ,
  • William T. Abraham, MD, FACC

      Affiliations

    • Division of Cardiovascular Medicine, Ohio State University, Columbus, OH

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.

Key Words: Heart failure, decompensated heart failure, apnea Hypopnea Index, central sleep apnea, obstructive sleep apnea

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 R.N.K. and W.T.A. have received research grants from Respironics, Inc.

PII: S1071-9164(09)00168-7

doi:10.1016/j.cardfail.2009.05.005

Journal of Cardiac Failure
Volume 15, Issue 9 , Pages 739-746, November 2009

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