Abstract
Background Sleep-disordered breathing (SDB) is a common yet a largely underdiagnosed entity in developing countries. It is one treatable condition that is known to adversely affect the mortality and morbidity in heart failure (HF). This study is one of the first attempts aimed at studying SDB in chronic HF patients from an Indian subcontinent. Objectives The aim of this study was to study the prevalence, type, and characteristics of SDB in chronic HF patients and their association with HF severity and left ventricular (LV) systolic function and also to determine the relevance of SDB symptoms and screening questionnaires such as the Epworth Sleepiness Scale (ESS), Berlins questionnaire, and STOP-BANG score in predicting SDB in chronic HF patients. Methods We enrolled 103 chronic heart failure patients aged more than 18 years. Patients with a history of SDB and recent acute coronary syndrome within 3 months were excluded. Relevant clinical data, anthropometric measures, echocardiographic parameters, and sleep apnea questionnaires were collected, and all patients underwent the overnight type 3 sleep study. Results The overall prevalence of SDB in our study was high at 81.55% (84/103), with a predominant type of SDB being obstructive sleep apnea (59.2%). The occurrence of SDB was significantly associated with the male gender (p = 0.002) and higher body mass index (BMI) values (p = 0.01). SDB symptoms and questionnaires like ESS, STOP-BANG, and Berlins also did not have a significant association with the occurrence of SDB in HF patients. Conclusions Our study showed a high prevalence of occult SDB predominantly OSA, in chronic HF patients. We advocate routine screening for occult SDB in HF patients.
Highlights
Sleep-disordered breathing (SDB) is a common yet a largely underdiagnosed entity in developing countries
A multivariate logistic regression analysis was done to see the predictors of SDB, and we found that the male gender and higher body mass index (BMI) values were independently associated with the occurrence of SDB (Table 3)
Our study has shown a very high prevalence of occult SDB in chronic heart failure patients compared to other Western studies
Summary
Sleep-disordered breathing (SDB) is a common yet a largely underdiagnosed entity in developing countries. It is one treatable condition that is known to adversely affect the mortality and morbidity in heart failure (HF). The overall prevalence of SDB in our study was high at 81.55% (84/103), with a predominant type of SDB being obstructive sleep apnea (59.2%). Our study showed a high prevalence of occult SDB predominantly OSA, in chronic HF patients. One of the known causes is severe nocturnal hypoxemia caused by sleep-disordered breathing (SDB), a common underlying condition in HF patients. Compared to the general population, SDB has a very high prevalence of around 50–80% in HF patients [1, 2] Both SDB and HF are common diseases in the general population which affect around 10% [3] and 2% [4] of them, respectively
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