Author + information
- Received August 12, 2015
- Revision received September 15, 2015
- Accepted September 21, 2015
- Published online February 1, 2016.
- Michael Arzt, MDa,∗ (, )
- Holger Woehrle, MDb,c,
- Olaf Oldenburg, MDd,
- Andrea Graml, Dipl Statc,
- Anna Suling, PhDe,
- Erland Erdmann, MDf,
- Helmut Teschler, MDg,
- Karl Wegscheider, PhDe,
- SchlaHF Investigators
- aDepartment of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany
- bSleep and Ventilation Center Blaubeuren, Respiratory Center Ulm, Ulm, Germany
- cResMed Science Center, Martinsried, Germany
- dDepartment of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Germany
- eDepartment of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- fClinic III for Internal Medicine, Heart Center University Hospital Cologne, Cologne, Germany
- gDepartment of Pneumology, Ruhrlandklinik, West German Lung Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany
- ↵∗Reprint requests and correspondence:
Dr. Michael Arzt, Schlafmedizinisches Zentrum, Klinik und Poliklinik für Innere Medizin II, Universitätsklinikum Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany.
Objectives This prospective study investigated the prevalence of sleep-disordered breathing (SDB) and its predictors in patients with stable chronic heart failure (HF).
Background SDB is increasingly recognized as being important in patients with HF.
Methods The multicenter SchlaHF (Sleep-Disordered Breathing in Heart Failure) registry provides demographic and clinical data on chronic, stable, symptomatic patients with HF (New York Heart Association functional class ≥II; left ventricular rejection fraction ≤45%). Moderate-to-severe SDB (apnea-hypopnea index ≥15/h) was determined by a 2-channel screening device (ApneaLink, ResMed, Sydney, Australia).
Results Data from 6,876 patients were analyzed. The prevalence of moderate-to-severe SDB was 46%, with a significant sex difference: 36% in women (n = 1,448) versus 49% in men (n = 5,428). Prevalence of SDB rose with increasing age (31%, 39%, 45%, 52%, and 59% in those age ≤50, >50 to 60, >60 to 70, >70 to 80, and >80 years, respectively). Risk factors for SDB were body mass index (per 5 units; odds ratio [OR]: 1.29; 95% confidence interval [CI]: 1.22 to 1.36), left ventricular rejection fraction (per 5% decrement from 45%; OR: 1.10; 95% CI: 1.06 to 1.14), age (per 10-year difference to 60 years; OR: 1.41; 95% CI: 1.34 to 1.49), atrial fibrillation (OR: 1.19; 95% CI: 1.06 to 1.34), and male sex (OR: 1.90; 95% CI: 1.67 to 2.17).
Conclusions SchlaHF registry data demonstrate a high prevalence of SDB in a representative population of stable patients with chronic HF receiving contemporary medical management. Male sex, age, body mass index, and the severity of both symptoms and left ventricular dysfunction were clinical predictors for prevalent SDB. (Prevalence, Clinical Characteristics and Type of Sleep-disordered Breathing in Patients With Chronic, Symptomatic, Systolic Heart Failure; NCT01500759)
The SchlaHF registry was funded by ResMed Ltd. (Sydney, Australia) and ResMed Germany Inc. (Martinsried, Germany). ResMed also provided funding for English language editing assistance by an independent medical writer (Nicola Ryan). Dr. Arzt received grant support from ResMed, Philips Home Healthcare Solutions, and the German Foundation for Cardiac Research (Deutsche Stiftung für Herzforschung); is the holder of an endowed professorship from the Free State of Bavaria at the University of Regensburg that was donated by ResMed and Philips Home Healthcare Solutions; and has previously received lecture fees from AstraZeneca, Philips Home Healthcare Solutions, and ResMed. Drs. Woehrle and Graml are employees of ResMed. Dr. Oldenburg has acted as a consultant for ResMed and Respicardia; has received a research grant from ResMed; and has received lecture honoraria from ResMed, Respicardia, and Weinmann. Dr. Erdmann received consulting fees or honoraria and travel grants from ResMed. Dr. Teschler received grant support from ResMed, the ResMed Foundation, and Linde; and has previously received lecture fees from AstraZeneca, Novartis, Linde, Boehringer Ingelheim, Berlin Chemie, and ResMed. Dr. Wegscheider received consulting fees or honoraria and travel grants from ResMed. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Drs. Arzt and Woehrle contributed equally to this work.
- Received August 12, 2015.
- Revision received September 15, 2015.
- Accepted September 21, 2015.
- 2016 American College of Cardiology Foundation