Prevalence and Physiological Predictors of Sleep Apnea in Patients With Heart Failure and Systolic Dysfunction

BackgroundPrevious studies reported high prevalences of obstructive and central sleep apnea (OSA and CSA, respectively) in patients with heart failure (HF). However, these preceded widespread use of β-blockers and spironolactone that might have reduced their prevalences. We therefore determined, in patients with HF, prevalences and predictors of OSA and CSA and the influence of changes in HF therapy on prevalences.Methods and ResultsA total of 218 HF patients with left ventricular ejection fraction (LVEF) ≤45% underwent sleep studies between 1997 and 2004 and were classified as having moderate to severe sleep apnea (apnea-hypopnea index ≥15hours of sleep, either OSA or CSA), or mild to no sleep apnea. The prevalence of moderate to severe OSA was 26% and of CSA was 21%. Predictors of OSA were older age, male sex, and greater body mass index, and of CSA were older age, male sex, atrial fibrillation, hypocapnia, and diuretic use. Between 1997 and 2004, the prevalences of OSA and CSA did not change significantly (Ptrend =.460, Ptrend =.211, respectively) despite increased use of β-blockers and spironolactone (Ptrend < .001, Ptrend < .001, respectively), and an increase in LVEF (Ptrend=.005).ConclusionsOSA and CSA remain common in patients with HF, despite increases in β-blocker and spironolactone use.