Baniak Lynn M, Chasens Eileen R
University of Pittsburgh, School of Nursing, 3500 Victoria St., Victoria Building, Pittsburgh, PA, 15261, United States.
Geriatr Nurs. 2018 Jan-Feb;39(1):77-83. doi: 10.1016/j.gerinurse.2017.07.001. Epub 2017 Aug 4.
Heart failure in older adults is frequently accompanied by sleep disordered breathing (SDB). Treatment of SDB in persons with heart failure with preserved ejection fraction (HFpEF) is unclear because most data is on heart failure with reduced ejection fraction (HFrEF). The purpose of this paper was to evaluate studies that report on the effects of positive airway pressure on patient outcomes in older adults with HFpEF and comorbid SDB. A search of the literature found six data-based studies (N = 36 to 126). Treatment with positive airway pressure reduced nighttime SDB symptoms and improved daytime functional status in persons with HFPEF and SDB (New York Heart Association Functional Class: effect sizes = -0.67 to -1.60). Limitations (i.e. only two studies were randomized controlled trials, small sample sizes, and women were under-represented) suggest that additional evidence is needed to guide treatment of SDB in older adults with HFpEF.
老年人心力衰竭常伴有睡眠呼吸障碍（SDB）。射血分数保留的心力衰竭（HFpEF）患者的SDB治疗尚不清楚，因为大多数数据来自射血分数降低的心力衰竭（HFrEF）。本文的目的是评估报告气道正压对患有HFpEF和合并SDB的老年人患者结局影响的研究。文献检索发现六项基于数据的研究（N = 36至126）。气道正压治疗可减轻HFPEF和SDB患者的夜间SDB症状，并改善白天功能状态（纽约心脏协会心功能分级：效应大小 = -0.67至-1.60）。局限性（即只有两项研究是随机对照试验、样本量小以及女性代表性不足）表明，需要更多证据来指导HFpEF老年患者的SDB治疗。
