TY - JOUR
T1 - Sleep duration and quality in heart failure patients
AU - Türoff, Anke
AU - Thiem, Ulrich
AU - Fox, Henrik
AU - Spießhöfer, Jens
AU - Bitter, Thomas
AU - Tamisier, Renaud
AU - Punjabi, Naresh M.
AU - Horstkotte, Dieter
AU - Oldenburg, Olaf
N1 - Funding Information:
Acknowledgements Core lab analysis of PSG recordings was sponsored by ResMed (who had no input into the study design, collection and interpretation of the data, writing of the report, or in the decision to submit for publication). English language editing assistance was provided by Nicola Ryan, independent medical writer, funded by ResMed.
Funding Information:
Conflicts of interest Henrik Fox and Olaf Oldenburg have received honoraria for lectures and travel expenses from ResMed and LivaNova and travel expenses from Novartis and Bayer. Thomas Bitter has received honoraria for lectures from ResMed and travel expenses from Novartis and Bayer. Renaud Tamisier has received an unrestricted grant from Resmed Foundation. Naresh M. Punjabi has received research grant support from Philips Respironics and Resmed. Anke Türoff, Ulrich Thiem, Jens Spießhöfer, and Dieter Horstkotte declare that they have no conflicts of interest.
Funding Information:
Core lab analysis of PSG recordings was sponsored by ResMed (who had no input into the study design, collection and interpretation of the data, writing of the report, or in the decision to submit for publication). English language editing assistance was provided by Nicola Ryan, independent medical writer, funded by ResMed. No funding was received.
Publisher Copyright:
© 2017, Springer-Verlag Berlin Heidelberg.
PY - 2017/12/1
Y1 - 2017/12/1
N2 - Purpose: Sleep-disordered breathing (SDB) is highly prevalent in patients with heart failure and reduced left ventricular ejection fraction (HF-REF). SDB is classified as predominant obstructive (OSA) or central (CSA) and may alter sleep duration, sleep quality, and quality of life. This study describes sleep quality and duration in well-characterized cohorts of these patients. Methods: Two hundred fifty consecutive patients with HF-REF (NYHA class ≥II, ejection fraction ≤45%) underwent cardiac and pulmonary examination, plus full attended in-hospital overnight polysomnography (PSG). PSG recordings were performed according to current recommendations and underwent independent, blinded analysis at a core laboratory. Results: Patients with HF-REF and CSA were older and had more impaired cardiac function compared to those with OSA. With respect to sleep parameters, patients with CSA spent more time in bed than those with OSA (468 ± 52 vs 454 ± 46 min, p = 0.021) while sleep efficiency was lower (67 ± 14 vs 72 ± 13% of total sleep time (TST), p = 0.008). In addition, CSA patients spent more time awake after sleep onset (101 ± 61 vs 71 ± 46 min, p = 0.001) and had more stage N1 (light) sleep (33 ± 19 vs 28 ± 16% of TST, p = 0.017). Overall, the proportion of sleep spent in N3 (slow-wave/deep) sleep in HF-REF patients with SDB was low (4.1 ± 6.3% of TST) compared with healthy adults. Conclusions: HF-REF patients with CSA compared to OSA have worse sleep efficiency and quality. This could result in less restorative sleep, changes in sympathovagal balance, and impaired resetting of important reflexes, which might contribute to worse cardiovascular outcomes in HF-REF patients with SDB.
AB - Purpose: Sleep-disordered breathing (SDB) is highly prevalent in patients with heart failure and reduced left ventricular ejection fraction (HF-REF). SDB is classified as predominant obstructive (OSA) or central (CSA) and may alter sleep duration, sleep quality, and quality of life. This study describes sleep quality and duration in well-characterized cohorts of these patients. Methods: Two hundred fifty consecutive patients with HF-REF (NYHA class ≥II, ejection fraction ≤45%) underwent cardiac and pulmonary examination, plus full attended in-hospital overnight polysomnography (PSG). PSG recordings were performed according to current recommendations and underwent independent, blinded analysis at a core laboratory. Results: Patients with HF-REF and CSA were older and had more impaired cardiac function compared to those with OSA. With respect to sleep parameters, patients with CSA spent more time in bed than those with OSA (468 ± 52 vs 454 ± 46 min, p = 0.021) while sleep efficiency was lower (67 ± 14 vs 72 ± 13% of total sleep time (TST), p = 0.008). In addition, CSA patients spent more time awake after sleep onset (101 ± 61 vs 71 ± 46 min, p = 0.001) and had more stage N1 (light) sleep (33 ± 19 vs 28 ± 16% of TST, p = 0.017). Overall, the proportion of sleep spent in N3 (slow-wave/deep) sleep in HF-REF patients with SDB was low (4.1 ± 6.3% of TST) compared with healthy adults. Conclusions: HF-REF patients with CSA compared to OSA have worse sleep efficiency and quality. This could result in less restorative sleep, changes in sympathovagal balance, and impaired resetting of important reflexes, which might contribute to worse cardiovascular outcomes in HF-REF patients with SDB.
KW - Central sleep apnea
KW - Heart failure
KW - Obstructive sleep apnea
KW - Sleep
KW - Sleep-disordered breathing
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U2 - 10.1007/s11325-017-1501-x
DO - 10.1007/s11325-017-1501-x
M3 - Article
C2 - 28389910
AN - SCOPUS:85017129312
SN - 1520-9512
VL - 21
SP - 919
EP - 927
JO - Sleep and Breathing
JF - Sleep and Breathing
IS - 4
ER -