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Published online before print March 14, 2007, 10.1183/09031936.00037106
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Eur Respir J 2007; 29:1201-1205
Copyright ©ERS Journals Ltd 2007

Sleep apnoea in heart failure

R. Schulz1, A. Blau2, J. Börgel3, H. W. Duchna4, I. Fietze2, I. Koper5, R. Prenzel6, S. Schädlich7, J. Schmitt8, S. Tasci9, S. Andreas10 for the working group "Kreislauf und Schlaf" of the German Sleep Society (DGSM)

1 University of Giessen Lung Centre, Giessen, 2 Charité University Hospital Berlin, Sleep Disorders Centre, Department of Cardiology/ Pulmonary Medicine, 3 Depts of Cardiology and 4 Pulmonary Medicine, Ruhr University Hospital-Bochum, Bochum, 5 Sana Hospital, Schleswig-Holstein, and 6 Pius Hospital, Niedersachsen, Oldenburg, 7 Department of Internal Medicine II, Hospital Martha-Maria Halle-Dolau, 8 Department of Internal Medicine III, Theresien Hospital, Mannheim, 9 Department of Cardiology/Pulmonary Medicine, University Hospital Bonn, Bonn, and 10 Department of Cardiology/Pulmonary Medicine, University Hospital Gottingen, Gottingen, Germany.

CORRESPONDENCE: R. Schulz, University of Giessen Lung Center, Klinikstr. 36, 35392 Giessen, Germany. Fax: 49 6419947999. E-mail: Richard.Schulz{at}innere.med.uni-giessen.de

Keywords: Cheyne–Stokes respiration, congestive heart failure, obstructive sleep apnoea

Received: March 15, 2006
Accepted February 27, 2007

Studies from the USA have reported that sleep apnoea is common in congestive heart failure (CHF), with Cheyne–Stokes respiration (CSR) being the most frequent type of sleep-disordered breathing (SDB) in these patients. Within the present study, the authors sought to assess the prevalence and type of SDB among CHF patients in Germany.

A total of 203 CHF patients participated in this prospective multicentre study. All patients were stable in New York Heart Association classes II and III and had a left ventricular ejection fraction (LVEF) <40%. The patients were investigated by polygraphy and all data were centrally analysed. Patient enrolment was irrespective of sleep-related symptoms.

The majority of patients were male with a mean age of 65 yrs and hospitalised. Of the 203 patients, 145 (71%) had an apnoea/hypopnoea index >10·h–1, obstructive sleep apnoea (OSA) occurred in 43% (n = 88) and CSR in 28% (n = 57) of patients.

The prevalence of sleep-disordered breathing is high in patients with stable severe congestive heart failure from a European population. As sleep-disordered breathing may have a negative impact on the prognosis of congestive heart failure, a sleep study should be performed in every patient with congestive heart failure and a left ventricular ejection fraction of <40%. This diagnostic approach should probably be adopted for all of these patients irrespective of the presence of sleep-related symptoms.




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