Obstructive sleep apnoea and heart failure

2017 ◽  
Vol 20 (01) ◽  
pp. 9-16 ◽  
Keyword(s):  
Heart Failure ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Obstructive Sleep

P4404Prognostic value of novel nocturnal oxygen saturation metrics in patients with obstructive sleep apnoea and high cardiovascular event risk

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D Linz ◽  
K Loffler ◽  
P Sanders ◽  
P Catcheside ◽  
C Anderson ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Oxygen Saturation ◽  
Obstructive Sleep Apnoea ◽  
Controlled Trial ◽  
Characteristic Curve ◽  
Sleep Apnoea ◽  
Time Ratio ◽  
Event Risk ◽  
Obstructive Sleep

Abstract Aim To determine prognostic value of novel oximetry-derived metrics in patients with obstructive sleep apnoea (OSA) and high cardiovascular (CV) event risk. Methods and results Ancillary study of the Sleep Apnoea CV Endpoints (SAVE) randomised controlled trial, which investigated the effects of CPAP treatment on secondary CV event outcomes in 2687 participants with moderate-severe OSA and established CV disease. Associations between baseline characteristics, standard sleep and pulse oximetry-derived metrics, and CV outcomes were determined in Cox proportional hazards regression models stratified for treatment allocation. Metrics evaluated included: oxygen desaturation index, time below 90% oxygen saturation (SpO2), average SpO2across recordings (mean SpO2), across episodic desaturation events (desaturation SpO2), and baseline interpolated through episodic desaturation events (baseline SpO2); duration and desaturation/resaturation time ratio of episodic desaturation events; and mean and standard deviation of pulse rate. No SpO2 metric was associated with the composite outcome. Mean and baseline SpO2 were negatively associated with heart failure (hazard ratio [HR] 0.81, 95% confidence interval [CI] 0.69–0.95; P=0.009 and 0.78, 0.67–0.90; P=0.001, respectively) and myocardial infarction risk (0.86, 0.77–0.95; P=0.003 and 0.81, 0.73–0.90; P<0.001, respectively) and marginally positively associated with stroke risk (1.09, 1.00–1.20; P=0.065 and 1.13, 1.02–1.26; P=0.020, respectively). Desaturation duration and desaturation/resaturation time ratio, with established risk factors, predicted heart failure (area under the receiver-operating-characteristic curve 0.86, 95% CI 0.79–0.93). Conclusions Higher mean and baseline SpO2 were associated with reduced risk of heart failure and myocardial infarction, and small increases in stroke rate. Desaturation shape may have predictive utility for future CV events. Clinical trial registration: clinicaltrials (NCT00738179).

scholarly journals Impact of Obstructive Sleep Apnoea on Heart Failure with Preserved Ejection Fraction

2016 ◽  
Vol 25 (5) ◽  
pp. 435-441 ◽  
Author(s):  
Takuo Arikawa ◽  
Shigeru Toyoda ◽  
Akiko Haruyama ◽  
Hirohisa Amano ◽  
Shu Inami ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Preserved Ejection Fraction ◽  
Obstructive Sleep

scholarly journals Sleeping Beauty or the Beast? – The Metabolic Syndrome from an Obstructive Sleep Apnoea Perspective

2010 ◽  
Vol 9 (1) ◽  
pp. 12 ◽  
Author(s):  
Lise Tarnow ◽  
Brigitte Klinkenbijl ◽  
Holger Woehrle ◽  
◽  
◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Obstructive Sleep Apnoea ◽  
Reduce Blood Pressure ◽  
Sleep Apnoea ◽  
Sleeping Beauty ◽  
The Metabolic Syndrome ◽  
Home Based ◽  
Obstructive Sleep

Obstructive sleep apnoea (OSA) is a significant health issue. Patients with cardiovascular disease as well as patients with diabetes have a high prevalence of OSA, and the prevalence of coronary heart disease, heart failure, stroke and diabetes is increased in patients with obstructive sleep apnoea. Physiological responses to OSA include sympathetic activation, neurohumoral changes and inflammation, all of which are precursors for cardiovascular disease and diabetes. International guidelines are starting to recognise the importance of OSA for patients with cardiovascular conditions such as heart failure and hypertension. Diagnosis is important, and home-based sleep testing devices can facilitate this process. Treating OSA with continuous positive airway pressure (CPAP) has been shown to reduce blood pressure (BP) in patients with hypertension, but more research is needed to determine which components of the metabolic syndrome respond best to the addition of CPAP therapy.

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