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Copyright ©ERS Journals Ltd 2006
Symptom burden of sleep-disordered breathing in mild-to-moderate congestive heart failure patients
1 Clinical and Academic Unit of Sleep and Breathing, National Heart and Lung Institute, Imperial College, and 2 Cardiac Medicine, and 3 Sleep and Ventilation Unit, Royal Brompton Hospital, London, UK.
CORRESPONDENCE: M. J. Morrell, Sleep and Ventilation Unit, 2nd floor, Royal Brompton Hospital, Fulham Road, London, SW3 6NP, UK. Fax: 44 2073518911. E-mail: m.morrell{at}imperial.ac.uk
Keywords: Actigraphy, activity, daytime sleepiness, heart failure, napping
Received: May 31, 2005
Accepted December 12, 2005
The symptom burden resulting from sleep-disordered breathing (SDB) in patients with mild-to-moderate congestive heart failure (CHF) is unclear. The current authors monitored 24-h activity levels and compared subjective and objective measures of daytime sleepiness in 39 CHF patients, New York Heart Association class 2–3, on optimal medication. A total of 22 patients were classified as SDB (apnoea/hypopnoea index (AHI) median (range) 22.3 (16.6–100) events·h–1), and 17 as no SDB (NoSDB; AHI 3.7 (0–12.3) events·h–1). SDB was defined as AHI
The duration of daytime activity was significantly shorter in the SDB group compared with the NoSDB group. The SDB group also had increased time in bed and poorer sleep quality, as shown by the fragmentation index. Objectively the SDB group when compared with the NoSDB group were significantly sleepier, subjectively the groups did not differ. The amount of napping was similar for both groups.
Despite the lack of subjective symptoms of daytime sleepiness, congestive heart failure patients with sleep-disordered breathing were objectively sleepier during the day and had reduced daytime activity with longer periods in bed and poorer sleep quality when compared with those without sleep-disordered breathing.
15 events·h–1. Patients were assessed by 24-h activity monitoring (actigraphy) for a period of up to 14 days, a single objective sleepiness test (Oxford Sleep Resistance test) and Epworth Sleepiness Scale.
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