PREVALENCE OF SLEEP-DISORDERED BREATHING IN PATIENTS ON A HEART-TRANSPLANT WAITING LIST

We investigated the prevalence of sleep-disordered breathing in 20 out patients on a heart transplant waiting list. All were younger than 60 years and had severe stable cardiac failure with a cardiac index below 2.5 L/min/m(2) and a left ventricular ejection fraction below 25%. Ni ne patients (45%) exhibited ten or more apneas and hypopneas per hour of sleep (apneic group). fn all patients but one, apneas and hypopneas were predominantly of the central type and occurred during Cheyne-Sto kes respiration. There were no statistically significant differences b etween the apneic and nonapneic groups of patients in terms of age (51 +/-5 years vs 49+/-11); body mass index (24+/-4 kg/m(2) vs 22+/-3), ca rdiac index (1.87+/-0.35 L/min/m(2) vs 1.84+/-0.40), isotopic left ven tricular ejection fraction(13+/-5 vs 12+/-3%), arterial blood gas, or pulmonary function tests. Hypnogram characteristics showed poorer slee p quality in the apneic group than in the nonapneic group, with a larg er number of arousals; this difference was found both for arousals las ting more than 30 s (8+/-5/h vs 4+/-2) and for arousals lasting less t han 30 s (18+/-16/h vs 5+/-6) and was associated with increased wakefu lness after sleep onset in the apneic group (138+/-82 min vs 84+/-45). Arousals were strongly associated with hyperpneic phases of Cheyne-St okes respiration. We conclude that sleep-disordered breathing is commo n in patients with end-stage heart disease and adversely affects the q uality of sleep.