Chest
Clinical InvestigationsSLEEP AND BREATHINGImpact of Sleep Apnea on Sympathetic Nervous System Activity in Heart Failure
Section snippets
Subjects
Patients being assessed by the Alfred Hospital Heart Failure Service and healthy volunteers were invited to take part in this study. Consecutive patients with CHF of either gender who were aged 18 to 75 years were enrolled if they met the following criteria: (1) clinical evidence of symptomatic CHF of at least 6 months duration and receiving medical therapy; (2) a left ventricular ejection fraction (LVEF) of ≤ 55% and New York Heart Association class II to IV; and (3) stable condition, which
Comparison Among the Normal, OSA, and CHF Groups
The demographic characteristics of the normal group (n = 15), the OSA group (n = 15), and the CHF group (n = 90; unselected for apnea) were similar, apart from the subjects in the normal group being 8 years younger than those in the CHF group (Table 1). The OSA and CHF groups had similar AHI values, movement arousal index values, and mean and minimum Spo2 values. The CHF group had lower amounts of total and REM sleep than did the normal group. Furthermore, the CHF group had a greater mean sleep
Discussion
Although CHF, OSA, and CSA are known to be associated with elevated SNSA, their relative contributions have not been previously investigated. In this study, the overnight UNE level was used as an integrated marker of SNSA when patients were asleep, and awake invasive hemodynamic pressures were measured in a large population of, mainly male, CHF patients and then was compared with that of healthy male volunteers without sleep apnea and male OSA subjects who were free of heart disease. Two
References (29)
- et al.
Heart rate and cardiovascular mortality: the Framingham study
Am Heart J
(1987) - et al.
Relationship of arousals from sleep to sympathetic nervous system activity and BP in obstructive sleep apnea
Chest
(1999) - et al.
Sympathetic nervous system alterations in sleep apnea: the relative importance of respiratory disturbance, hypoxia, and sleep quality
Chest
(1997) - et al.
Effect of Cheyne-Stokes respiration on muscle sympathetic nerve activity in severe congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy
Am J Cardiol
(1998) - et al.
Abnormalities of pulmonary artery wedge pressures in sleep-induced apnea
Int J Cardiol
(1981) - et al.
Can periodic breathing have advantages for oxygenation?
J Theor Biol
(1995) - et al.
Doppler evaluation of changing cardiac dynamics during Cheyne-Stokes respiration
Chest
(1989) - et al.
Plasma norepinephrine as a guide to prognosis in patients with chronic congestive heart failure
N Engl J Med
(1984) Clinical aspects of sympathetic activation and parasympathetic withdrawal in heart failure
J Am Coll Cardiol
(1993)- et al.
Sympathetic neural mechanisms in obstructive sleep apnea
J Clin Invest
(1995)
Combined hypoxia and hypercapnia evokes long-lasting sympathetic activation in humans
J Appl Physiol
Effects of nasal CPAP on sympathetic activity in patients with heart failure and central sleep apnea
Am J Respir Crit Care Med
Sympathetic activity in obese subjects with and without obstructive sleep apnea
Circulation
Sympathetic-nerve activity during sleep in normal subjects
N Engl J Med
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This research was supported by the Australian National Health and Medical Research Council, the Australian Lung Foundation, the Viertal Foundation, and an Alfred Research Grant.