TY - JOUR T1 - Bigger numbers needed! JF - European Respiratory Journal JO - Eur Respir J SP - 659 LP - 660 DO - 10.1183/09031936.04.00013304 VL - 23 IS - 5 AU - H.F. Becker Y1 - 2004/05/01 UR - http://erj.ersjournals.com/content/23/5/659.abstract N2 - In this issue of the European Respiratory Journal, Roebuck et al. 1 assess the effect of Cheyne-Stokes respiration (CSR) on mortality in patients with heart failure. Of the 78 patients, the largest patient group studied so far, CSR was present in 33 (42%). After 500 days of follow-up, mortality was increased in patients with CSR, but after a median of 52 months of follow-up, this difference was no longer present. Congestive heart failure is one of the leading causes of morbidity and mortality in developed countries and, despite advances in pharmacological therapy, incidence rates are still rising. Ever since the description of apnoeas followed by a waxing and waning breathing pattern (Cheyne 1818 and Stokes 1854), the occurrence of breathing disturbances in chronic congestive heart failure has been recognised in the medical community. However, until a couple of years ago, many may have thought that CSR was a rare condition occurring in a few patients with end-stage heart failure or severe stroke. In fact, several studies published in recent years uniformly demonstrate that CSR is a very common problem in patients with stable congestive heart failure, with prevalence rates ranging 33–40% 2, 3. CSR leads to several unfavourable consequences: hypoxia, arousal from sleep, sympathetic activation, blood pressure … ER -