Respiratory Unit, Hospital Taiping, Ministry of Health Malaysia, Perak, Malaysia.
Clinical Research Centre, Hospital Taiping, Ministry of Health Malaysia, Perak, Malaysia.
J R Coll Physicians Edinb. 2024 Mar;54(1):18-25. doi: 10.1177/14782715241239704. Epub 2024 Mar 20.
The presence of sleep-disordered breathing (SDB) in congestive heart failure (CHF) is associated with poor prognosis and is underdiagnosed despite advances in CHF management. The prevalence of SDB in CHF remains understudied in South East Asia.
A prospective, observational single-centre study was conducted where 116 consecutive patients in a specialised heart failure clinic underwent level 1, attended polysomnography (PSG).
The prevalence of SDB was 78% using the apnoea-hypopnea index (AHI), AHI ⩾ 5/h threshold, and 59% with the AHI ⩾ 15/h threshold. Obstructive sleep apnoea (OSA) was the predominant type of SDB and was associated with increased body mass index and neck circumference. STOP-BANG was predictive of SDB, especially in men. Central sleep apnoea (CSA) patients had worse sleep indexes and lower awake arterial carbon dioxide. SDB was also homogenously present in preserved ejection fraction (EF) CHF.
Most of the CHF patients were found to have SDB with the utility of PSG. Local CHF guidelines should include sleep testing for all patients with CHF.The study is registered on ClinicalTrials.gov (NCT05332223) as 'The Epidemiological Characteristics of SDB in Patients with Reduced or Preserved EF CHF'.
充血性心力衰竭（CHF）患者存在睡眠呼吸障碍（SDB）与预后不良有关，尽管 CHF 管理取得了进展，但仍存在漏诊。在东南亚，CHF 中 SDB 的患病率仍研究不足。
进行了一项前瞻性、观察性的单中心研究，在专门的心力衰竭诊所中，116 例连续患者接受了 1 级、 attended 多导睡眠图（PSG）检查。
使用呼吸暂停低通气指数（AHI）、AHI ⩾ 5/h 阈值，SDB 的患病率为 78%，使用 AHI ⩾ 15/h 阈值，患病率为 59%。阻塞性睡眠呼吸暂停（OSA）是 SDB 的主要类型，与体重指数和颈围增加有关。STOP-BANG 预测 SDB，尤其是在男性中。中枢性睡眠呼吸暂停（CSA）患者的睡眠指标较差，清醒时动脉血二氧化碳较低。SDB 在射血分数保留的 CHF 中也均匀存在。
大多数 CHF 患者通过 PSG 发现存在 SDB。当地的 CHF 指南应包括所有 CHF 患者的睡眠测试。该研究在 ClinicalTrials.gov（NCT05332223）上注册为“射血分数降低或保留的 CHF 患者 SDB 的流行病学特征”。
