6533b85bfe1ef96bd12bb3d5

RESEARCH PRODUCT

Sleep disordered breathing in patients with cardiovascular comorbidities hospitalized for pulmonary disease

subject

description

Sleep disordered breathing (SDB) is often overlooked in hospitalized patients. We screened consecutive patients with cardiovascular (CV) comorbidities hospitalized for respiratory problems to study SDB prevalence and type. Patients did not refer typical clinical signs of SDB. Patients (n=34, 21 M, mean age±SD 71±12 yr, BMI: 31.9±5.8 kg/m2) were studied by polygraphy (SomnoLab, Weinmann, Germany) 4.5±3.2 days after admission for COPD exacerbation (COPD-E, n=20), pleural effusion (n=2), asthma exacerbation (n=2) or other causes (n=10). On admission, 18 patients showed respiratory failure (RF, hypoxemic: n=9, hypercapnic: n=9). CV comorbidities (1.7±0.8/patient) were: hypertension (n= 27), heart failure (n=3), arrhythmias (n=11), coronary artery (n=15) or cerebrovascular (n=3) disease. Results showed: AHI≤5 (n=5, 14.7%), AHI≤15+nocturnal hypoxemia (n=3, 8.8%), obstructive (n=16, 47.1%), and central/complex SDB (n=10, 29.4%). Mean AHI was higher in the latter group (28.0±14.5/h) compared to patients with obstructive SDB (15.0±14.0/h), nocturnal hypoxemia (6.3±2.4/h) or AHI≤5 (3.1±1.0/h, p=0.005 by ANOVA). SDB type and severity were similar in men and women, and distribution of SDB type was unaffected by COPD-E or RF. The number of CV comorbidities tended to be highest in patients with central/complex SDB, and lowest in those with nocturnal hypoxemia (p=0.08 by ANOVA, NS). Therefore, 76% of patients with CV comorbidities hospitalized for respiratory problems showed obstructive or central/complex SDB. Central SDB were more severe but less frequent than obstructive SDB, and female gender did not protect against SDB in this population. Funded by ERS STRTF 5329-2013.