Does beta-blocker treatment influence central sleep apnoea?
Chronic severe heart failure is frequently associated with disturbances in the central control of breathing. During wakefulness, central breathing disorders could be ameliorated with beta-blocker treatment, but nothing is known about the effects of beta-blockers on the control of breathing during sleep. This study intends to determinate the prevalence and severity of nocturnal apnoeas and hypopnoeas in heart failure patients treated with or without metoprolol or carvedilol. Fifty consecutive patients with dilated cardiomyopathy in NYHA class II-IV with a left ventricular ejection fraction (LVEF) of 35% or below were studied with full polysomnography over one night. The mean Apnoea-Hypopnoea Index of beta-blocker free patients was 19.8+/-14.2 versus 7.4+/-8.5 (p<0.05) and 8.7+/-8.1 (p<0.05) in patients treated with metoprolol or carvedilol, respectively. The arousal index, sleep quality, and daytime sleepiness were improved in similar magnitude.


CONCLUSIONS
Long-term treatment of patients with advanced chronic heart failure with sufficient doses of metoprolol or carvedilol is associated with a lower prevalence and severity of central sleep apnoea (CSA).
Köhnlein
Thomas
T
Department of Respiratory Medicine, Medizinische Hochschule Hannover (Hannover Medical School), Carl-Neuberg-Strasse 1, D-30625 Hannover, Germany. thomas.koehnlein@web.de
Welte
Tobias
T
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D002227:Carbazoles / Q000627:therapeutic use*; D002303:Cardiac Output, Low / Q000150:complications / Q000188:drug therapy; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000188:drug therapy*; D000077261:Carvedilol; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008790:Metoprolol / Q000627:therapeutic use*; D008875:Middle Aged; D011412:Propanolamines / Q000627:therapeutic use*; D012891:Sleep Apnea Syndromes / Q000188:drug therapy / Q000209:etiology*; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D008790:Metoprolol