Prevalence of sleep-disordered breathing in a 316-patient French cohort of stable congestive heart failure

Background. - Heart failure with systolic dysfunction occurs frequently. Studies in North America and Germany have shown a high prevalence of steep-disordered breathing in patients with heart failure. Aims. - To assess the prevalence of sleep-disordered breathing and its associated risk factors in French patients with heart failure. Methods. - A total of 316 patients with stable heart failure and a left ventricular ejection fraction less or equal to 45% underwent polygraphy prospectively to diagnose steep apnoea syndrome, defined as an apnoea-hypopnoea index greater or equal to 10events/h. Results. - Mean age, left ventricular ejection fraction, and body mass index were 59 +/- 13 years, 30 +/- 11% and 28 +/- 6kg/m(2), respectively. The prevalence of steep breathing disorder was 81% (n = 256); 30% of syndromes were classified as central and 70% as obstructive. The mean apnoea-hypopnoea index was high (30 +/- 3 events/h) and a large proportion (41%) of syndromes had an apnoea-hypopnoea index greater or equal to 30 events/h. A central sleep apnoea syndrome pattern was associated with more severe heart failure and a more elevated apnoea-hypopnoea index than an obstructive pattern. The prevalence of steep-disordered breathing was lower in women than in men (64% versus 85%; chi(2) = 0.0003) as was its severity (mean apnoea-hypopnoea index 15 +/- 13 events/h versus 27 +/- 19 events/h, p = 0.0001). Conclusion. - The prevalence of steep-disordered breathing was high in a French heart failure population, with most syndromes having an obstructive pattern. Prevalence and severity were higher in men than in women. (C) 2009 Elsevier Masson SAS. All rights reserved.