TY - JOUR
T1 - Differential impact of body position on the severity of disordered breathing in heart failure patients with obstructive vs. central sleep apnoea
AU - Pinna, Gian Domenico
AU - Robbi, Elena
AU - La Rovere, Maria Teresa
AU - Taurino, Anna Eugenia
AU - Bruschi, Claudio
AU - Guazzotti, Giampaolo
AU - Maestri, Roberto
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Aims Obstructive (OSA) and central sleep apnoea (CSA) are a common comorbidity in patients with heart failure. The purpose of this study was to assess and compare the impact of body position on the severity of sleep apnoea in these two groups of patients. Methods and results Standard polysomnography was performed in consecutive, clinically stable, optimally treated patients with moderate-to-severe heart failure and systolic dysfunction. Patients with an apnoea-hypopnoea index (AHI) ≥15/h (n = 120) were included in the study. The severity of sleep-disordered breathing was quantified by the AHI, the mean value of oxygen desaturations (O2desat) and the apnoea ratio. Data from the right and left positions were combined into a single lateral position. Positional sleep apnoea was defined as a >50% reduction in the AHI between the supine and the lateral position. Twenty-nine and 91 subjects had dominant OSA and CSA, respectively. The AHI markedly decreased from the supine to the lateral position in both groups [OSA: (median [q1,q3]) 50.3 [36.9, 67.6]/h vs. 10.4 [7.0, 18.5]/h, P <0.0001; CSA: 47.4 [37.6, 56.0]/h vs. 19.3 [11.9, 33.3]/h]. The reduction was greater in OSA patients (p = 0.027). Similarly, O2desat and the apnoea ratio decreased in the lateral position (P <0.0001). Positional sleep apnoea was observed in 76% of OSA and 53% of CSA patients (P = 0.028). Conclusion This study demonstrates that the lateral sleeping position has a major beneficial effect on the severity of sleep-disordered breathing in heart failure patients, and that this improvement is greater in subjects with OSA than in those with CSA.
AB - Aims Obstructive (OSA) and central sleep apnoea (CSA) are a common comorbidity in patients with heart failure. The purpose of this study was to assess and compare the impact of body position on the severity of sleep apnoea in these two groups of patients. Methods and results Standard polysomnography was performed in consecutive, clinically stable, optimally treated patients with moderate-to-severe heart failure and systolic dysfunction. Patients with an apnoea-hypopnoea index (AHI) ≥15/h (n = 120) were included in the study. The severity of sleep-disordered breathing was quantified by the AHI, the mean value of oxygen desaturations (O2desat) and the apnoea ratio. Data from the right and left positions were combined into a single lateral position. Positional sleep apnoea was defined as a >50% reduction in the AHI between the supine and the lateral position. Twenty-nine and 91 subjects had dominant OSA and CSA, respectively. The AHI markedly decreased from the supine to the lateral position in both groups [OSA: (median [q1,q3]) 50.3 [36.9, 67.6]/h vs. 10.4 [7.0, 18.5]/h, P <0.0001; CSA: 47.4 [37.6, 56.0]/h vs. 19.3 [11.9, 33.3]/h]. The reduction was greater in OSA patients (p = 0.027). Similarly, O2desat and the apnoea ratio decreased in the lateral position (P <0.0001). Positional sleep apnoea was observed in 76% of OSA and 53% of CSA patients (P = 0.028). Conclusion This study demonstrates that the lateral sleeping position has a major beneficial effect on the severity of sleep-disordered breathing in heart failure patients, and that this improvement is greater in subjects with OSA than in those with CSA.
KW - Central sleep apnoea
KW - Heart failure
KW - Obstructive sleep apnoea
KW - Positional sleep apnoea
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U2 - 10.1002/ejhf.410
DO - 10.1002/ejhf.410
M3 - Article
C2 - 26467056
AN - SCOPUS:84949508324
VL - 17
SP - 1302
EP - 1309
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
SN - 1388-9842
IS - 12
ER -