Sleep-Disordered Breathing Occurs Frequently in Stable Outpatients With Congestive Heart Failure

Sleep apnoea screening in heart failure? Not until benefit is proven!

“…There were, however, large differences in the frequency of obstructive versus central apnoeas in these studies, which cannot be explained by differences in age, ethnicity, sex or medication, including angiotensin-converting enzyme inhibitors or b-blockers. The use of b-blockers, for example, was similar in the study by MARED et al [18] and FERRIER et al [19], but the frequency of central apnoeas and Cheyne-Stokes respiration differed considerably. All of these studies used different criteria to define central sleep apnoea in CheyneStokes respiration.…”

“…MARED et al [18] observed that 66% of Swedish males and females with CHF had Cheyne-Stokes respiration and only 4% had OSA. In a study from New Zealand, however, FERRIER et al [19] observed that only 15% of patients had central sleep apnoea and as many as 52% of patients had OSA. Taken together, these studies report sleep-disordered breathing in 50-70% of patients with CHF.…”

Assessment of Human Natriuretic Peptides (B), Human N-Terminal Pro-BNP and Nor-epinephrine as Neurohumoral Markers in Sleep Disordered Breathing among Heart Failure Patients in Upper Egypt

“…Also, Ferrier et al measured urinary catecholamines, and NT-BNP in 87 HF patients with left ventricular ejection fraction (LVEF<45%) and reported a significant increase in norepinephrine (NE) (P=0.013) and (NT-pro BNP) (P=0.001 * ) among HF with SDB [7]. Another study by Paulino et al who evaluated the prevalence of sleep apnea and measured plasma concentration level of BNP among 316 French patients with stable heart failure and demonstrated a significant increase in plasma concentration level of BNP in OSA patients as compared with CSA and No-SDB (501 ± 244 vs. 406 ± 50 pg/ml in CSA) and (501 ± 244 vs. 205 ± 44 pg/ml in CSA) [8].…”

Investigation of the link between fluid shift and airway collapsibility as a mechanism for obstructive sleep apnea in congestive heart failure

“…An a‐priori apnea‐hypopnea index (AHI) threshold of 10 events/h was used to determine the presence of OSA (Ferrier et al. 2005; Schulz et al. 2007).…”