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Sleep‐disordered breathing in a general heart failure population: relationships to neurohumoral activation and subjective symptoms
Author(s) -
RAO ARCHANA,
GEORGIADOU PANAGIOTA,
FRANCIS DARREL P.,
JOHNSON ANDREW,
KREMASTINOS DIMITRIS TH.,
SIMONDS ANITA K.,
COATS ANDREW J. S.,
COWLEY ALAN,
MORRELL MARY J.
Publication year - 2006
Publication title -
journal of sleep research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.297
H-Index - 117
eISSN - 1365-2869
pISSN - 0962-1105
DOI - 10.1111/j.1365-2869.2006.00494.x
Subject(s) - medicine , heart failure , epworth sleepiness scale , population , cardiology , excessive daytime sleepiness , polysomnography , brain natriuretic peptide , quality of life (healthcare) , natriuretic peptide , sleep disorder , apnea , psychiatry , insomnia , nursing , environmental health
Summary The aim of this study was to determine the prevalence of sleep‐related breathing disorders (SDB) in a UK general heart failure (HF) population, and assess its impact on neurohumoral markers and symptoms of sleepiness and quality of life. Eighty‐four ambulatory patients (72 male, mean (SD) age 68.6 (10) yrs) attending UK HF clinics underwent an overnight recording of respiratory impedance, SaO 2 and heart rate using a portable monitor (Nexan). Brain natriuretic peptide (BNP) and urinary catecholamines were measured. Subjective sleepiness and the impairment in quality of life were assessed (Epworth Sleepiness Scale (ESS), SF‐36 Health Performance Score). SDB was classified using the Apnoea/Hypopnoea Index (AHI). The prevalence of SDB (AHI > 15 events h −1 ) was 24%, increasing from 15% in mild‐to‐moderate HF to 39% in severe HF. Patients with SDB had significantly higher levels of BNP and noradrenaline than those without SDB (mean (SD) BNP: 187 (119) versus 73 (98) pg mL −1 , P = 0.02; noradrenaline: 309 (183) versus 225 (148) nmol/24 h, P = 0.05). There was no significant difference in reported sleepiness or in any domain of SF‐36, between groups with and without SDB (ESS: 7.8 (4.7) versus 7.5 (3.6), P = 0.87). In summary, in a general HF clinic population, the prevalence of SDB increased with the severity of HF. Patients with SDB had higher activation of a neurohumoral marker and more severe HF. Unlike obstructive sleep apnoea, SDB in HF had little discernible effect on sleepiness or quality of life as measured by standard subjective scales.