Prevalence and Patterns of Obstructive Sleep Apnea in Asian Indians With Congestive Heart Failure (original) (raw)
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Journal of Clinical Respiratory Diseases and Care, 2017
Central sleep apnea (CSA) rather than obstructive sleep apnea (OSA) is widely believed to be the dominant form of sleep apnea (SA) in patients with heart failure (HF). Hitherto, no study has characterized sleep disordered breathing (SDB) in Indian subjects with heart failure and evaluated its impact on severity of HF, which this study attempts to do. A retrospective data-analysis was done in 65 consecutive patients with stable mild-to-moderate HF referred for evaluation on the basis of fatigue and excessive daytime somnolence (EDS) regarded by the institute's cardiologists. Patients with ejection fraction (EF) <55% or LV fractional shortening of 28% were included in the study. PSG was scored according to current AASM recommendations. Based on the Apnea-Hypopnea Index (AHI), OSA was classified as mild (AHI:5-15), moderate (AHI: 15-30) and severe (AHI: >30). HF was arbitrarily classified as mild (EF:<35%) moderate (EF:35-45%) and severe (EF:45-55%). OSA emerged as the exclusive form of SA (95.4%; n=65) and was more severe in males. Patients with more severe HF tended to be less obese, and interestingly to have less severe OSA. In contrast to Western literature, OSA seems to be by far the most prevalent form of sleep apnea in Indian subjects with HF. HF mortality is known to be high in underweight individuals yet, persons with severe HF are often less obese and partly by reason of a lower BMI, appear to be relatively protected against severe OSA and severe nocturnal hypoxemia. This study thus raises important and intriguing questions which merit further enquiry.
Journal of Natural Science, Biology and Medicine, 2020
Background: Obstructive sleep apnea (OSA) is closely associated with metabolic diseases such as hypertension and dyslipidemia. OSA is also frequently found in patients with heart failure. This study aims to determine the prevalence and factors which affect the incidence of OSA in patients with heart failure. Methods: This cross-sectional study was conducted on 70 samples of patients with heart failure in the cardiac outpatient clinic and inpatient ward of the Persahabatan Hospital, Jakarta, Indonesia. Results: Using the Berlin Questionnaire, 42 patients (60%) were found to be at high risk of OSA. Using the Chi-square test, it was found that age (P = 0.988), gender (P = 0.678), body mass index (P = 0.170), neck circumference (P = 0.605), abdominal circumference (P = 0.189), blood pressure (P = 0.922), and smoking (P = 0.678) factors did not have a significant correlation with OSA risk in patients with heart failure. While the tonsil size was found to have a significant correlation (P...
International Journal of Advances in Medicine, 2022
Background: The aim of the study was to explore whether there is a relationship between Cardiovascular (CV) comorbidities and the prevalence and severity of Obstructive sleep apnea (OSA). Methods: Secondary data analysis of 146 patients with suspected sleep-disordered breathing was conducted who were presented to the department of medicine, KIMS Hospital, Hyderabad, from June 2021 to November 2021. Participants aged ≥18 years were included in the analysis. Demographic details, clinical history, comorbidities, medication history, were analyzed. AHI score, ODI (Oxygen desaturation index) score and average O2 saturation were recorded with the help of a home sleep testing device. Data were entered and analyzed with Epi info 7. Results: The overall prevalence of OSA was 78.8% in patients with suspected sleep-disordered breathing. Prevalence of mild, moderate, and severe OSA was 28.8%, 15.1%, and 34.9%, respectively. Proportions of diabetes and hypertension were significantly high among patients with obstructive sleep apnea. Correlation analysis revealed a weak positive linear relationship (r=0.14) between the number of risk factors and the AHI score. Conclusions: This study showed high prevalence of OSA among out patients presented with suspected sleep disordered breathing. Hypertension, diabetes and obesity were highly prevalent CV comorbidities among South Indian patients diagnosed with OSA.
Prevalence and profile of sleep disordered breathing amongst patients with congestive heart failure
Indian Journal of Sleep Medicine, 2010
Introduction: It has been observed that since heart failure is highly prevalent and central sleep apnea (CSA) is common in patients with a failing heart, heart failure is the commonest cause of CSA in the general population. Aims & Objectives: The present study was undertaken with the purpose of finding prevalence of sleep disordered breathing (SDB) in patients of heart failure and also to find the association of severity of SDB with severity of heart failure. Material & Methods: Forty patients suffering from systolic heart failure were selected on random basis. All these patients underwent complete evaluation of history, physical examination and overnight polysomnography. The patients were divided into two groups, namely group 1 and group 2, on the basis of polysomnography. Group 1 consisted of 17 patients who did not have sleep disordered breathing i.e. AHI (central or obstructive) < 5. Group 2 consisted of 23 patients who had sleep disordered breathing i.e. AHI (central or obstructive) > 5. Comparison of biochemical profile and sleep parameters was made between group 1 and group 2 and results analyzed. Observations: Aetiology of heart failure was ischemic heart disease in 34 patients, viral myocarditis in 3 patients and postpartum cardiomyopathy in 3 patients. Total prevalence of CSA in heart failure was 57.5%.Prevelance in males and females was 47.6% and 68.42% respectively. There was a significant difference in O2 desaturation index, minimum O2, arousal index, total sleep time, AHI (central), sleep efficiency and wake O2 amongst the two groups. A negative correlation was observed between ejection fraction and O2 desaturation index, AHI (central), and arousal index. A positive correlation was found between ejection fraction and wake O2. Conclusions: A fairly high prevalence of sleep-disordered breathing (57.5%) was found in patients of heart failure in the present study. With increasing severity of HF a significant worsening of CSA-CSR was observed. The treatment of CSA-CSR may prevent the worsening status of HF. Hence long term randomized and controlled interventions are required to further substantiate these fact.
Journal of Cardiac Failure, 2011
Background: Sleep-disordered breathing (SDB) is common in patients with reduced ejection fraction (EF). However, little is known about the prevalence of SDB in a general heart failure population including patients with preserved EF (HFPEF). Methods: We prospectively enrolled stable heart failure outpatients from our heart failure clinic to assess the prevalence of SDB independent of systolic left ventricular function. Results: Among 115 patients (62% with reduced EF, 38% with preserved EF, New York Heart Association Class II-IV) SDB was present in 81% (27% central sleep apnea, 54% obstructive sleep apnea [OSA]). HFPEF patients had SDB in 80% of the cases, 62% had OSA. This group had significantly more hypertension. Conclusions: This study shows a high prevalence of SDB in a general heart failure population, also in patients with HFPEF. These patients have predominantly OSA. Especially in patients with HFPEF SDB should be kept in mind and referral to a sleep specialist should be considered. (J Cardiac Fail 2011;17:420e425)
Sleep apnea syndrome and heart failure—mechanisms and consequences
Pneumologia
Heart failure (HF) remains a major public health issue despite advances in treatment, being associated with increased morbidity and mortality, multiple hospitalization and, implicitly, very high economic costs. Therefore, it becomes increasingly important to identify and treat factors or comorbidities that contribute to the progression of HF. Breathing disorders during sleep (sleep-disordered breathing), especially sleep apnea syndrome, obstructive or central form, may be one of these factors.
Sleep apnea in congestive heart failure
2010
Obstructive sleep apnea (OSA) is a form of sleep disordered breathing in which pharyngeal muscle relaxation leads to recurrent nighttime apneas and hypopneas that, through increased afterload, intermittent hypoxia, and excess sympathetic activity, weaken the already failing heart. This review presents the current evidence regarding the complex relationship between OSA and heart failure (HF), including support for OSA as both a cause and consequence of HF. The impact of OSA on other cardiovascular diseases, such as hypertension, ischemic heart disease and arrhythmias, as they relate to HF development or exacerbation, also are reviewed.
The Profile of Romanian Patient with Central Sleep Apnea and Heart Failure
Internal Medicine, 2021
Sleep-related breathing disorders are highly prevalent in patients with established cardiovascular disease, especially Heart failure (HF). Central sleep apnea (CSAS) share several pathophysiological features with obstructive sleep apnea, but each with a unique pathology and specific treatment. There are considerably fewer published patient profile reports in association with CSAS-HF. The treatment for association CSAS-HF varies and depends on the etiology of respiratory disorder and leaves considerable room for improvement for future investigations. Despite progress over the last 3 decades, HF continues to have high morbidity and mortality rates. At this time, it is also uncertain whether CSAS is a consequence of HF with reduced ejection fraction or it is in fact a risk factor for the evolution of underlying cardiac pathology. Therefore, this retrospective study highlights the interaction between CSA and HF, with particular attention to age differences, a frequent reported risk fact...
The Relationship Between Congestive Heart Failure, Sleep Apnea, and Mortality in Older Men*
CHEST Journal, 2003
Study objectives: To examine the association of sleep apnea with heart disease. Design: Prospective study. Setting: Medical wards at the Veterans Affairs San Diego Healthcare System. Patients: Three hundred fifty-three randomly selected inpatient men. Measurements and results: Sleep was recorded for 2 nights in the hospital. Medical conditions were obtained from hospital medical records. Cox proportional hazards analyses indicated that patients with congestive heart failure (CHF) plus central sleep apnea (CSA) had shorter survival than those with just CHF, just sleep apnea (obstructive or central), or neither. Survival for those with obstructive sleep apnea (OSA) or CSA and no CHF was no different than for those with neither disorder. Follow-up analysis showed that for those with no CHF, neither CSA nor OSA shortened survival (p > 0.80). For those with CHF, having CSA shortened the life span with a hazard ratio of 1.66 (p ؍ 0.012), but having OSA had no effect. Patients with CHF had more severe sleep apnea than those with no heart disease. Conclusions: This study does not clarify the issues of cause and effect, but does reinforce the strong associations between sleep apnea and heart disease in elderly men. These data suggest that people with coronary disease should be regarded as a risk group for sleep apnea.