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Prevalence and risk factors of sleep apnoea in adult patients with CHD

Published online by Cambridge University Press:  29 November 2018

Gen Harada ,
Daiji Takeuchi ,
Kei Inai ,
Tokuko Shinohara  and
Toshio Nakanishi
Gen Harada
Affiliation:
Department of Pediatric Cardiology, Tokyo Women’s Medical University, Tokyo, Japan Division of Adult Congenital Heart Disease Life-long Care, Tokyo Women’s Medical University, Tokyo, Japan
Daiji Takeuchi*
Affiliation:
Department of Pediatric Cardiology, Tokyo Women’s Medical University, Tokyo, Japan Division of Adult Congenital Heart Disease Life-long Care, Tokyo Women’s Medical University, Tokyo, Japan
Kei Inai
Affiliation:
Department of Pediatric Cardiology, Tokyo Women’s Medical University, Tokyo, Japan Division of Adult Congenital Heart Disease Life-long Care, Tokyo Women’s Medical University, Tokyo, Japan
Tokuko Shinohara
Affiliation:
Department of Pediatric Cardiology, Tokyo Women’s Medical University, Tokyo, Japan Division of Adult Congenital Heart Disease Life-long Care, Tokyo Women’s Medical University, Tokyo, Japan
Toshio Nakanishi
Affiliation:
Department of Pediatric Cardiology, Tokyo Women’s Medical University, Tokyo, Japan Division of Adult Congenital Heart Disease Life-long Care, Tokyo Women’s Medical University, Tokyo, Japan
*
Author for correspondence: D. Takeuchi, MD, PhD, Department of Pediatric Cardiology, Tokyo Women’s Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan. Tel: 81-3-3353-8111; Fax: 81-3-3356-0441; E-mail: takeuchi.daiji@twmu.ac.jp
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Abstract

Background

Although sleep apnoea is an important disorder associated with cardiac events, data regarding its prevalence and risk factors in adult patients with CHD are limited.

Methods

In this study, patients underwent a sleep study in the hospital. Indications for admission were classified as heart failure, diagnostic catheterisation, interventional catheterisation, or arrhythmia. The prevalence, characteristics, and risk factors of sleep apnoea using a type 3 portable overnight polygraph in adult patients with CHD were evaluated.

Results

This study comprised 104 patients of median age 36 years with interquartile range of 28–48 years, admitted for heart failure 34% (n = 36), diagnostic catheterisation 26% (n = 27), interventional catheterisation 18% (n = 19), or arrhythmia 22% (n = 23). The prevalence of sleep apnoea, defined as a respiratory disturbance index ≥5, was 63% (n = 63), with a distribution of 37, 16, and 10% for mild (5≤ respiratory disturbance index <15), moderate (15⩽ respiratory disturbance index <30), and severe (respiratory disturbance index ≥30) sleep apnoea, respectively. A large majority of the sleep apnoea cases were categorised as obstructive sleep apnoea (92%, n = 58). The respiratory disturbance index ≥15 group had a significantly higher proportion of male patients and higher body mass index, noradrenaline level, and aortic blood pressure than the group without sleep apnoea (respiratory disturbance index <5). Multi-variable analysis showed that NYHA class ≥II, whose odds ratio 4.36, 95% confidence interval 1.09–20.87, and body mass index ≥25, whose odds ratio 4.29, 95% confidence interval 1.32–15.23, were independent risk factors for a respiratory disturbance index ≥15.

Conclusion

Our results showed a high prevalence of sleep apnoea in adult patients with CHD. Its unique haemodynamics may be associated with a high prevalence of sleep apnoea. Congestive heart failure and being overweight are important risk factors for sleep apnoea. Management of heart failure and general lifestyle improvements are important for controlling sleep apnoea symptoms in these patients.

Keywords

Sleep apnoeaadult CHDprevalencerisk factorsheart failure
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 1 , January 2019 , pp. 71 - 77
Copyright
© Cambridge University Press 2018 

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Footnotes

Cite this article: Harada G, Takeuchi D, Inai K, Shinohara T, Nakanishi T. (2018) Prevalence and risk factors of sleep apnoea in adult patients with CHD. Cardiology in the Young29: 71–77. doi: 10.1017/S1047951118001853

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