Cheyne-Stokes respiration in congestive heart failure: continuous positive airway pressure of 5-8 cm H2O for 1 year in five cases.
Five adult patients with congestive heart failure (CHF) due to dilated cardiomyopathy complicated by Cheyne-Stokes respiration/central sleep apnea (CSR/CSA) were treated with continuous positive airway pressure (CPAP) with an initial pressure of 5 cm H2O. Four patients were followed up for 12 months with CPAP of 5 cm H2O. The rest, a 93-year-old patient, was followed up for 30 months, and the CPAP was reset at 8 cm H2O due to worsened cardiac function after 6 months and it was reset at 6 cm H2O due to dryness of the nose after 23 months. For all the patients with nightly CPAP use for 6.0+/-1.4 h per day for a year, frequency of CSR/CSA was significantly reduced after 3 and 12 months with CPAP (p<0.05). Moreover, their symptoms, cardiac function and sleep quality were significantly improved after 3 months (p<0.05), and were maintained above the pre-CPAP levels after 12 months, except for the oldest patient whose cardiac function tended to deteriorate. The results suggest that CSR/CSA in CHF can be treated with CPAP set at a lower pressure than the conventional method, and that CPAP at 5-8 cm H2O is often effective in eliminating CSR/CSA, improving sleep quality, and presumably maintaining cardiac function.
Yasuma
Fumihiko
F
Department of Internal Medicine, Suzuka National Hospital, Suzuka, Japan. f-yasuma@mtb.biglobe.ne.jp
D000368:Aged; D000369:Aged, 80 and over; D000399:Air Pressure; D002639:Cheyne-Stokes Respiration / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D004452:Echocardiography; D004562:Electrocardiography; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D017286:Polysomnography; D013318:Stroke Volume; D016896:Treatment Outcome