Heart Failure & Sleep Disordered Breathing

Congestive heart failure (CHF) is a syndrome that affects millions worldwide:

  • In the USA there are 5.7 million people suffering from CHF and approx. 550,000 new cases per year [1].
  • In Europe there are 6.5 million people suffering from CHF and approx. 580,000 new cases per year [2].

Sleep disordered breathing (SDB) is strongly associated with heart failure:

  • Approximately 50% of heart failure patients experience SDB, with either Cheyne-Stokes respiration (CSR) or obstructive sleep apnea.
  • CSR is a form of disordered breathing characterized by a crescendo-decrescendo pattern of tidal volume. In heart failure patients it is seen in:
    • acute heart failure patients,
    • many clinically stable patients with heart failure, and
    • patients with left ventricular systolic dysfunction – a precursor of heart failure.

SDB worsens as the congestion due to the heart failure becomes more severe. For example:

  • CSR with central sleep apnoea (CSR-CSA) is a breathing disorder seen in up to 80% of patients with advanced CHF.
  • Studies have shown that independent of other risk factors for CSR-CSA patients the risk of mortality in CHF increases by up to three-fold [3-5].

SleepMinder is a no touch monitor so is ideally suited for long-term monitoring of respiration changes associated with heart failure.

References:

1. Heart disease and stroke statistics-2009 update, American Heart Association and American Stroke Association , Circulation. 2009;119:e21-e181.
2. Congestive heart failure worldwide markets, clinical status and product development opportunities, New Medicine, Inc. 1997: 1-40. Wilkerson Group Survey, 1998.
3. P.A. Lanfranchi et al. Prognostic Value of Nocturnal Cheyne- Stokes Respiration in Chronic Failure, Circulation 1999;99;1435-1440
4. L.J. Findley, C.W. Zwillich, S. Ancoli-Israel, D. Kripke, G. Tisi and K.M. Moser,Cheyne–Stokes breathing during sleep in patients with left ventricular heart failure, South Med J 78 (1985), pp. 11–15.
5. P.J. Hanly and N.S. Zuberi-Khokhar, Increased mortality associated with Cheyne–Stokes respiration in patients with congestive heart failure, Am J Respir Crit Care Med 153 (1996), pp. 272–276.