Relationship Between β-Blocker Treatment and the Severity of Central Sleep Apnea in Chronic Heart Failure

Background:We sought to examine the relationship between use of β-blockers and the severity of central sleep apnea (CSA) in patients with chronic heart failure.Methods:We performed polysomnography in 45 patients with chronic heart failure (New York Heart Association functional class II/III and left ventricular ejection fraction < 50%) and examined the relationship between use of β-blockers and the severity of CSA. Central apnea index (CAI) was used as an indicator of CSA.Results:Patients receiving β-blockers (ie, carvedilol; n = 27) had lower apnea-hypopnea index (AHI) and CAI than patients not receiving β-blockers (n = 18) [mean ± SD, 14 ± 11 vs 33 ± 17, p < 0.0001; and 1.9 ± 3.2 vs 11 ± 12, p = 0.0004, respectively]. AHI and CAI were negatively correlated with the dose of carvedilol (Spearman ρ = − 0.61, p < 0.0001; and Spearman ρ = − 0.57, p = 0.0002, respectively). Multiple regression analysis selected no use of β-blockers as an independent factor of CAI (p = 0.0006). In five patients with CAI > 5 who underwent serial sleep studies, CAI decreased significantly after 6 months of treatment with carvedilol (9.5 ± 4.9 to 1.3 ± 2.4, p = 0.03).Conclusions:In patients with chronic heart failure, CAI was lower according to the dose of β-blockers, and no use of β-blockers was independently associated with CAI. In addition, 6 months of treatment with carvedilol decreased CAI. These results suggest that β-blocker therapy may dose-dependently suppress CSA in patients with chronic heart failure.