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Am. J. Respir. Crit. Care Med., Volume 160, Number 4, October 1999, 1101-1106

Risk Factors for Central and Obstructive Sleep Apnea in 450 Men And Women with Congestive Heart Failure

DON D. SIN, FABIA FITZGERALD, JOHN D. PARKER, GARY NEWTON, JOHN S. FLORAS, and T. DOUGLAS BRADLEY

Sleep Research Laboratory of the Toronto Rehabilitation Institute and the Departments of Medicine, The Toronto Hospital and Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada

In previous analyses of the occurrence of central (CSA) and obstructive sleep apnea (OSA) in patients with congestive heart failure (CHF), only men were studied and risk factors for these disorders were not well characterized. We therefore analyzed risk factors for CSA and OSA in 450 consecutive patients with CHF (382 male, 68 female) referred to our sleep laboratory. Risk factors for CSA were male gender (odds ratio [OR] 3.50; 95% confidence interval [CI], 1.39 to 8.84), atrial fibrillation (OR 4.13; 95% CI 1.53 to 11.14), age > 60 yr (OR 2.37; 95% CI 1.35 to 4.15), and hypocapnia (PCO2 < 38 mm Hg during wakefulness) (OR 4.33; 95% CI 2.50 to 7.52). Risk factors for OSA differed by gender: in men, only body mass index (BMI) was significantly associated with OSA (OR for a BMI > 35 kg/m2, 6.10; 95% CI 2.86 to 13.00); whereas, in women, age was the only important risk factor (OR for age > 60 yr, 6.04; 95% CI 1.75 to 20.0). We conclude that historical information, supplemented by a few simple laboratory tests may enable physicians to risk stratify CHF patients for the presence of CSA or OSA, and the need for diagnostic polysomnography for such patients. Sin DD, Fitzgerald F, Parker JD, Newton G, Floras JS, Bradley TD. Risk factors for central and obstructive sleep apnea in 450 men and women with congestive heart failure.




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 NEJMHome page
T. D. Bradley, A. G. Logan, R. J. Kimoff, F. Series, D. Morrison, K. Ferguson, I. Belenkie, M. Pfeifer, J. Fleetham, P. Hanly, et al.
Continuous Positive Airway Pressure for Central Sleep Apnea and Heart Failure.
N. Engl. J. Med., November 10, 2005; 353(19): 2025 - 2033.
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 NEJMHome page
V. K. Somers
Sleep -- A New Cardiovascular Frontier
N. Engl. J. Med., November 10, 2005; 353(19): 2070 - 2073.
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 ChestHome page
K. Ferrier, A. Campbell, B. Yee, M. Richards, T. O'Meeghan, M. Weatherall, and A. Neill
Sleep-Disordered Breathing Occurs Frequently in Stable Outpatients With Congestive Heart Failure
Chest, October 1, 2005; 128(4): 2116 - 2122.
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 ChestHome page
M. A. Martinez-Garcia, R. Galiano-Blancart, P. Roman-Sanchez, J.-J. Soler-Cataluna, L. Cabero-Salt, and E. Salcedo-Maiques
Continuous Positive Airway Pressure Treatment in Sleep Apnea Prevents New Vascular Events After Ischemic Stroke
Chest, October 1, 2005; 128(4): 2123 - 2129.
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 HeartHome page
L J Cormican and A Williams
Sleep disordered breathing and its treatment in congestive heart failure
Heart, October 1, 2005; 91(10): 1265 - 1270.
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 ChestHome page
P. McKeown and A. E. Epstein
Future Directions: American College of Chest Physicians Guidelines for the Prevention and Management of Postoperative Atrial Fibrillation After Cardiac Surgery
Chest, August 1, 2005; 128(2_suppl): 61S - 64S.
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 Eur Respir JHome page
J. Y. Gabor, D. A. Newman, V. Barnard-Roberts, V. Korley, I. Mangat, P. Dorian, and P. J. Hanly
Improvement in Cheyne-Stokes respiration following cardiac resynchronisation therapy
Eur. Respir. J., July 1, 2005; 26(1): 95 - 100.
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 Am. J. Respir. Crit. Care Med.Home page
L. Luthje, C. Unterberg-Buchwald, D. Dajani, D. Vollmann, G. Hasenfuss, and S. Andreas
Atrial Overdrive Pacing in Patients with Sleep Apnea with Implanted Pacemaker
Am. J. Respir. Crit. Care Med., July 1, 2005; 172(1): 118 - 122.
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 Am. J. Respir. Crit. Care Med.Home page
T. Brack, A. Jubran, F. Laghi, and M. J. Tobin
Fluctuations in End-Expiratory Lung Volume during Cheyne-Stokes Respiration
Am. J. Respir. Crit. Care Med., June 15, 2005; 171(12): 1408 - 1413.
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 Eur Respir JHome page
C. Sahlin, E. Svanborg, H. Stenlund, and K. A. Franklin
Cheyne-Stokes respiration and supine dependency
Eur. Respir. J., May 1, 2005; 25(5): 829 - 833.
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 ChestHome page
F. Series, R. J. Kimoff, D. Morrison, M. H. Leblanc, M. Smilovitch, J. Howlett, A. G. Logan, J. S. Floras, and T. D. Bradley
Prospective Evaluation of Nocturnal Oximetry for Detection of Sleep-Related Breathing Disturbances in Patients With Chronic Heart Failure
Chest, May 1, 2005; 127(5): 1507 - 1514.
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 ChestHome page
C. Carmona-Bernal, E. Quintana-Gallego, M. Villa-Gil, A. Sanchez-Armengol, A. Martinez-Martinez, and F. Capote
Brain Natriuretic Peptide in Patients With Congestive Heart Failure and Central Sleep Apnea
Chest, May 1, 2005; 127(5): 1667 - 1673.
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 Am. J. Respir. Crit. Care Med.Home page
C. Nopmaneejumruslers, Y. Kaneko, V. Hajek, V. Zivanovic, and T. D. Bradley
Cheyne-Stokes Respiration in Stroke: Relationship to Hypocapnia and Occult Cardiac Dysfunction
Am. J. Respir. Crit. Care Med., May 1, 2005; 171(9): 1048 - 1052.
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 ChestHome page
M. Arzt, M. Schulz, R. Wensel, S. Montalvan, F. C. Blumberg, G. A. J. Riegger, and M. Pfeifer
Nocturnal Continuous Positive Airway Pressure Improves Ventilatory Efficiency During Exercise in Patients With Chronic Heart Failure
Chest, March 1, 2005; 127(3): 794 - 802.
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 ChestHome page
C. M. Ryan and T. D. Bradley
Periodicity of Obstructive Sleep Apnea in Patients With and Without Heart Failure
Chest, February 1, 2005; 127(2): 536 - 542.
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 ChestHome page
R. W. Peters
Obstructive Sleep Apnea and Cardiovascular Disease
Chest, January 1, 2005; 127(1): 1 - 3.
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 ChestHome page
M. A. Skinner, M. S. Choudhury, S. D.R. Homan, J. O. Cowan, G. T. Wilkins, and D. R. Taylor
Accuracy of Monitoring for Sleep-Related Breathing Disorders in the Coronary Care Unit
Chest, January 1, 2005; 127(1): 66 - 71.
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 Eur Respir JHome page
E. Quintana-Gallego, M. Villa-Gil, C. Carmona-Bernal, G. Botebol-Benhamou, A. Martinez-Martinez, A. Sanchez-Armengol, J. Polo-Padillo, and F. Capote
Home respiratory polygraphy for diagnosis of sleep-disordered breathing in heart failure
Eur. Respir. J., September 1, 2004; 24(3): 443 - 448.
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 Mayo Clin Proc.Home page
J. M. Parish and V. K. Somers
Obstructive Sleep Apnea and Cardiovascular Disease
Mayo Clin. Proc., August 1, 2004; 79(8): 1036 - 1046.
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 CirculationHome page
A. S. Gami, G. Pressman, S. M. Caples, R. Kanagala, J. J. Gard, D. E. Davison, J. F. Malouf, N. M. Ammash, P. A. Friedman, and V. K. Somers
Association of Atrial Fibrillation and Obstructive Sleep Apnea
Circulation, July 27, 2004; 110(4): 364 - 367.
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