Differential impact of body position on the severity of disordered breathing in heart failure patients with obstructive vs. central sleep apnoea
- PMID: 26467056
- DOI: 10.1002/ejhf.410
Differential impact of body position on the severity of disordered breathing in heart failure patients with obstructive vs. central sleep apnoea
Abstract
Aims: Obstructive (OSA) and central sleep apnoea (CSA) are a common comorbidity in patients with heart failure. The purpose of this study was to assess and compare the impact of body position on the severity of sleep apnoea in these two groups of patients.
Methods and results: Standard polysomnography was performed in consecutive, clinically stable, optimally treated patients with moderate-to-severe heart failure and systolic dysfunction. Patients with an apnoea-hypopnoea index (AHI) ≥15/h (n = 120) were included in the study. The severity of sleep-disordered breathing was quantified by the AHI, the mean value of oxygen desaturations (O2 desat) and the apnoea ratio. Data from the right and left positions were combined into a single lateral position. Positional sleep apnoea was defined as a >50% reduction in the AHI between the supine and the lateral position. Twenty-nine and 91 subjects had dominant OSA and CSA, respectively. The AHI markedly decreased from the supine to the lateral position in both groups [OSA: (median [q1,q3]) 50.3 [36.9, 67.6]/h vs. 10.4 [7.0, 18.5]/h, P < 0.0001; CSA: 47.4 [37.6, 56.0]/h vs. 19.3 [11.9, 33.3]/h]. The reduction was greater in OSA patients (p = 0.027). Similarly, O2 desat and the apnoea ratio decreased in the lateral position (P < 0.0001). Positional sleep apnoea was observed in 76% of OSA and 53% of CSA patients (P = 0.028).
Conclusion: This study demonstrates that the lateral sleeping position has a major beneficial effect on the severity of sleep-disordered breathing in heart failure patients, and that this improvement is greater in subjects with OSA than in those with CSA.
Keywords: Central sleep apnoea; Heart failure; Obstructive sleep apnoea; Positional sleep apnoea.
© 2015 The Authors European Journal of Heart Failure © 2015 European Society of Cardiology.
Similar articles
-
The reduction of central sleep apnoea severity in the left lateral position is not due to an improvement in cardiac haemodynamics in patients with chronic heart failure.Sleep Med. 2017 Jun;34:30-32. doi: 10.1016/j.sleep.2017.02.023. Epub 2017 Mar 18. Sleep Med. 2017. PMID: 28522095
-
Impact of sleeping position on central sleep apnea/Cheyne-Stokes respiration in patients with heart failure.Sleep Med. 2010 Feb;11(2):143-8. doi: 10.1016/j.sleep.2009.05.014. Epub 2010 Jan 21. Sleep Med. 2010. PMID: 20093078 Clinical Trial.
-
Prognostic impact of sleep-disordered breathing and its treatment with nocturnal ventilation for chronic heart failure.Eur J Heart Fail. 2012 Sep;14(9):1009-19. doi: 10.1093/eurjhf/hfs085. Epub 2012 Jun 22. Eur J Heart Fail. 2012. PMID: 22730336
-
Sleep-disordered breathing in heart failure.Eur J Heart Fail. 2016 Apr;18(4):353-61. doi: 10.1002/ejhf.492. Epub 2016 Feb 11. Eur J Heart Fail. 2016. PMID: 26869027 Review.
-
Sleep apnoea in heart failure: To treat or not to treat?Respirology. 2017 Feb;22(2):217-229. doi: 10.1111/resp.12964. Epub 2016 Dec 20. Respirology. 2017. PMID: 27998040 Review.
Cited by
-
Effect of lateral position on rostral fluid shift and relationship to severity of Cheyne-Stokes respiration in heart failure patients.Sleep Breath. 2024 May;28(2):789-796. doi: 10.1007/s11325-023-02969-z. Epub 2023 Dec 16. Sleep Breath. 2024. PMID: 38102508
-
Cardiovascular diseases across OSA phenotypes: A retrospective cohort study.Sleep Med X. 2023 Oct 14;6:100090. doi: 10.1016/j.sleepx.2023.100090. eCollection 2023 Dec 15. Sleep Med X. 2023. PMID: 37927891 Free PMC article.
-
Depth-Camera-Based Under-Blanket Sleep Posture Classification Using Anatomical Landmark-Guided Deep Learning Model.Int J Environ Res Public Health. 2022 Oct 18;19(20):13491. doi: 10.3390/ijerph192013491. Int J Environ Res Public Health. 2022. PMID: 36294072 Free PMC article.
-
Positional obstructive sleep apnea in patients with atrial fibrillation.Sleep Breath. 2023 May;27(2):487-494. doi: 10.1007/s11325-022-02625-y. Epub 2022 May 10. Sleep Breath. 2023. PMID: 35538180 Free PMC article.
-
Association of Night-to-Night Adherence of Continuous Positive Airway Pressure With Day-to-Day Morning Home Blood Pressure and Its Seasonal Variation in Obstructive Sleep Apnea.J Am Heart Assoc. 2022 Apr 5;11(7):e024865. doi: 10.1161/JAHA.121.024865. Epub 2022 Mar 24. J Am Heart Assoc. 2022. PMID: 35322679 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical