Should we screen for sleep apnoea in heart failure? If we do, how should we treat these patients?
Sleep Apnoea in Heart Failure: Our studies have shown that over 50% of patients with mild symptomatic chronic heart failure (secondary to left ventricular systolic dysfunction) have sleep apnoea (Vazir 2007). The health and economic burden of this level of disease is considerable, since heart failure patients with sleep apnoea appear to have a worse prognosis. Although they may be difficult to diagnose as they do not always have symptoms of sleepiness (Hastings 2006).
Our current projects, funded by the British Heart Foundation, are focused on developing screening methods to detect sleep apnoea in heart failure patients using heart rate variability. The advantage of this methodology is that 24hour ECG is establish in most cardiology departments and patients are familiar it, therefore it is likely to be cheaper and better tolerated than respiratory diagnosis.
References
Vazir A, Hastings PC, Dayer M, McIntyre HF, Henein MY, Poole-Wilson PA, Cowie MR, Morrell MJ, Simonds AK. A high prevalence of sleep disordered breathing in men with mild symptomatic chronic heart failure due to left ventricular systolic dysfunction. Eur J Heart failure. 2007 Mar;9(3):243-50.
Hastings PC, Vazir A, O'Driscoll DM, Morrell MJ, Simonds AK. Symptom burden of sleep disordered breathing in mild-to-moderate congestive heart failure patients. Eur Resp J.2006 Apr;27(4):748-55.
Vazir A, Dayer M, Hastings PC, McIntyre HF, Henein MY, Poole-Wilson PA, et al. Can heart rate variation rule out sleep-disordered breathing in heart failure? Eur Resp J. 2006 March 1, 2006;27(3):571-7
