Clinical Investigations In-hospital Testing for Sleep-disordered Breathing in Hospitalized Patients With Decompensated Heart Failure: Report of Prevalence and Patient Characteristics

Background: Sleep-disordered breathing (SDB) is present in more than 50% of ambulatory patients with chronic heart failure. The prevalence and type of SDB in hospitalized patients with acutely decompensated heart failure (ADHF) are not known. Methods and Results: In-hospital sleep studies were performed on consecutive patients with ADHF who were not previously tested for SDB. A total of 395 consecutive patients with ADHF underwent successful sleep study recording during hospitalization. A total of 298 patients (75%, 95% CI [71e80%] had SDB; of these, 226 (57%, 95% CI [52e62]) had predominantly obstructive SDB and 72 (18%, 95% CI [14e22]) hadpredominantlycentralSDB.Only25%(95%CI20e29%)ofpatientswerefreeofSDB.Validationpolysomnography between 6 and 8 weeks after discharge on a subgroup of unselected patients with obstructive SDB revealed a 100 % positive predictive value (95% CI 94e100%) for obstructive sleep apnea (OSA). Conclusions: Similar to stable chronic heart failure, ADHF is associated with a high prevalence of SDB. The prevalence of predominantly obstructive SDB exceeded that of predominantly central SDB in ADHF patients. The presence of obstructive SDB during hospitalization predicted a diagnosis of OSA on polysomnography. (J Cardiac Fail 2009;15:739e746)