PMID- 18339776
OWN - NLM
STAT- MEDLINE
DCOM- 20080731
LR  - 20170530
IS  - 0012-3692 (Print)
IS  - 0012-3692 (Linking)
VI  - 133
IP  - 6
DP  - 2008 Jun
TI  - Sleep-related breathing disorders in patients with pulmonary hypertension.
PG  - 1375-1380
LID - S0012-3692(08)60075-6 [pii]
LID - 10.1378/chest.07-3035 [doi]
AB  - BACKGROUND: Cheyne-Stokes respiration (CSR) and central sleep apnea (CSA) are 
      common in patients with left-heart failure. We investigated the hypothesis that 
      sleep-disordered breathing is also prevalent in patients with right ventricular 
      dysfunction due to pulmonary hypertension (PH). METHODS: We studied 38 
      outpatients (median age, 61 years; quartiles, 51 to 72) with pulmonary arterial 
      hypertension (n = 23) or chronic thromboembolic PH (n = 15). New York Heart 
      Association (NYHA) class was II to IV, and median 6-min walk distance was 481 m 
      (quartiles, 429 to 550). In-laboratory polysomnography (n = 22) and ambulatory 
      cardiorespiratory sleep studies (n = 38) including pulse oximetry were performed. 
      Quality of life and sleepiness by the Epworth sleepiness score were assessed. 
      RESULTS: The median apnea/hypopnea index was 8 events/h (quartiles, 4 to 19), 
      with 8 central events (quartiles, 4 to 17), and 0 obstructive events (quartiles, 
      0 to 0.3) per hour. Seventeen patients (45%) had > or = 10 apnea/hypopnea 
      events/h. Comparison of 13 patients with > or = 10 CSR/CSA events/h with 21 
      patients with < 10 CSR/CSA events/h (excluding 4 patients with > or = 10 
      obstructive events/h from this analysis) revealed no difference in regard to 
      hemodynamics, NYHA class, and Epworth sleepiness scores. However, patients with > 
      or = 10 CSR/CSA events/h had a reduced quality of life in the physical domains. 
      Ambulatory cardiorespiratory sleep studies accurately predicted > or = 10 
      apnea/hypopnea events/h during polysomnography in patients who underwent both 
      studies (area under the receiver operating characteristic curve, 0.93; SE +/- 
      0.06; p = 0.002). The corresponding value for pulse oximetry was 0.63 +/- 0.14 (p 
      = not significant). CONCLUSIONS: In patients with PH, CSR/CSA is common, but 
      obstructive sleep apnea also occurs. Sleep-related breathing disorders are not 
      associated with excessive sleepiness but affect quality of life. They should be 
      evaluated by polysomnography or cardiorespiratory sleep studies because pulse 
      oximetry may fail to detect significant sleep apnea.
FAU - Ulrich, Silvia
AU  - Ulrich S
AD  - Pulmonary Division, University Hospital Zurich, Zurich, Switzerland.
FAU - Fischler, Manuel
AU  - Fischler M
AD  - Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland.
FAU - Speich, Rudolf
AU  - Speich R
AD  - Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland.
FAU - Bloch, Konrad E
AU  - Bloch KE
AD  - Pulmonary Division, University Hospital Zurich, Zurich, Switzerland. Electronic 
      address: pneubloc@usz.uzh.ch.
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20080313
PL  - United States
TA  - Chest
JT  - Chest
JID - 0231335
SB  - IM
MH  - Aged
MH  - Cheyne-Stokes Respiration/*complications
MH  - Female
MH  - Humans
MH  - Hypertension, Pulmonary/classification/*complications
MH  - Male
MH  - Middle Aged
MH  - Oximetry
MH  - Polysomnography
MH  - Quality of Life
MH  - ROC Curve
MH  - Sleep Apnea, Obstructive/classification/*complications
MH  - Sleep Stages
EDAT- 2008/03/15 09:00
MHDA- 2008/08/01 09:00
CRDT- 2008/03/15 09:00
PHST- 2008/03/15 09:00 [pubmed]
PHST- 2008/08/01 09:00 [medline]
PHST- 2008/03/15 09:00 [entrez]
AID - S0012-3692(08)60075-6 [pii]
AID - 10.1378/chest.07-3035 [doi]
PST - ppublish
SO  - Chest. 2008 Jun;133(6):1375-1380. doi: 10.1378/chest.07-3035. Epub 2008 Mar 13.