In-hospital testing for sleep-disordered breathing in hospitalized patients with decompensated heart failure: report of prevalence and patient characteristics.
BACKGROUND
Sleep-disordered breathing (SDB) is present in more than 50% of ambulatory patients with chronic heart failure. The prevalence and type of SDB in hospitalized patients with acutely decompensated heart failure (ADHF) are not known.


RESULTS
In-hospital sleep studies were performed on consecutive patients with ADHF who were not previously tested for SDB. A total of 395 consecutive patients with ADHF underwent successful sleep study recording during hospitalization. A total of 298 patients (75%, 95% CI [71-80%] had SDB; of these, 226 (57%, 95% CI [52-62]) had predominantly obstructive SDB and 72 (18%, 95% CI [14-22]) had predominantly central SDB. Only 25% (95% CI 20-29%) of patients were free of SDB. Validation polysomnography between 6 and 8 weeks after discharge on a subgroup of unselected patients with obstructive SDB revealed a 100 % positive predictive value (95% CI 94-100%) for obstructive sleep apnea (OSA).


CONCLUSIONS
Similar to stable chronic heart failure, ADHF is associated with a high prevalence of SDB. The prevalence of predominantly obstructive SDB exceeded that of predominantly central SDB in ADHF patients. The presence of obstructive SDB during hospitalization predicted a diagnosis of OSA on polysomnography.
Khayat
Rami N
RN
Division of Pulmonary Critical Care and Sleep, Ohio State University, Columbus, OH, USA. rami.khayat@osumc.edu
Jarjoura
David
D
Patt
Brian
B
Yamokoski
Todd
T
Abraham
William T
WT
D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems / Q000592:standards*; D017286:Polysomnography / Q000379:methods / Q000592:standards; D015995:Prevalence; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology