Polysomnographic characteristics and cardiac function in coronary artery disease patients with nonsleepy obstructive sleep apnoea

We compared polysomnography (PSG) results and cardiac function in patients with nonsleepy vs sleepy obstructive sleep apnoea (OSA) in a coronary artery disease (CAD) cohort.For the current protocol, 384 PSG recordings of CAD patients with OSA (apnea-hypopnea index [AHI] ≥15/h on cardiorespiratory polygraphy) from the RICCADSA trial, conducted in Sweden between 2005 and 2013, were evaluated. In all, 234 patients were nonsleepy (Epworth Sleepiness Scale [ESS] score <10), and 150 were sleepy (ESS score ≥10). Total sleep time (TST), sleep efficiency, sleep stages, AHI, and Oxygen Desaturation Index (ODI) were compared. Left ventricular ejection fraction (LVEF) and plasma levels of N-terminal pro-brain natriuric peptide (NT-proBNP) were also evaluated.Compared to the sleepy OSA, the nonsleepy patients had shorter TST (mean 369 vs 395 min; p=0.007) and less severe ODI; 20.8/h vs 25.8/h; p=0.007) despite the same level of AHI (41.1 vs 42.0/h; n.s). No significant between-group differences were observed regarding the other PSG variables. Proportion of patients with LVEF <50% tended to be higher (15.7% vs 9.7%; p=0.078) in the nonsleepy OSA group, who had significantly higher NT-proBNP values (579 vs 337 pmol/L; p<0.001).Shorter TST, increased NT-proBNP and decreased LVEF in nonsleepy OSA might be related with increased sympathetic activity. Whether or not these patients require an even higher adherence to OSA treatment for cardiovascular outcomes, or an improvement of ...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Sleep and control of breathing Source Type: research