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. 2024 Sep 24;13(19):5676.
doi: 10.3390/jcm13195676.

CPAP Treatment at Home after Acute Decompensated Heart Failure in Patients with Obstructive Sleep Apnea

Petar Kalaydzhiev  1   2 , Angelina Borizanova  1   2 , Neli Georgieva  1   2 , Gergana Voynova  2 , Slavi Yakov  2 , Tsvetan Kocev  2 , Galya Tomova-Lyutakova  1   2 , Bozhidar Krastev  1   2 , Natalia Spasova  1   2 , Radostina Ilieva  1   2 , Elena Kinova  1   2 , Assen Goudev  1   2
Affiliations

CPAP Treatment at Home after Acute Decompensated Heart Failure in Patients with Obstructive Sleep Apnea

Petar Kalaydzhiev et al. J Clin Med. .

Abstract

Background: Acute decompensated heart failure (ADHF) is a condition with a high frequency of hospitalizations and mortality, and obstructive sleep apnea (OSA) is a common comorbidity. Continuous positive airway pressure (CPAP) therapy at home can be a good adjunctive non-drug therapy for these patients. Methods: We conducted a single-center, prospective cohort study from 150 consecutive patients hospitalized for heart failure exacerbation in the cardiology department. Of these, 57 patients had obstructive sleep apnea. After discharge, CPAP therapy at home was offered. We divided them into two groups and followed them for 1 year. All patients received optimal medical treatment. At the end of the period, patients underwent a follow-up physical examination, a follow-up echocardiography, and a follow-up evaluation of the Epworth Sleepiness Scale (ESS). Results: From 81 patients with sleep apnea, 72.8% (n = 59) had obstructive sleep apnea (OSA) and 27.2% (n = 22) had central sleep apnea (CSA). There was a statistically significant difference in body mass index (BMI), ESS, systolic blood pressure (SBP), diastolic blood pressure (DBP), and left ventricular ejection fraction (LVEF%) in the group with CPAP therapy compared to the no-CPAP group. The CPAP group had a median survival of 11.7 months vs. 10.1 months in the no-CPAP group (log-rank (Mantel-Cox) p = 0.044). Conclusions: This study suggests that obstructive sleep apnea is a common comorbidity in patients with acute decompensated heart failure. The addition of CPAP therapy in these patients improves the symptoms and the prognosis.

Keywords: acute decompensated heart failure; continuous positive airway pressure therapy; obstructive sleep apnea.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
BMI at the start and at the end of the study in patients with and without CPAP. The follow-up period was 12 months. BMI—body mass index; CPAP—continuous positive airway pressure. Results are expressed as mean ± SD.
Figure 2
Figure 2
Change in ESS from baseline to end of follow-up in the CPAP and non-CPAP groups. The follow-up period was 12 months. ESS—Epworth Sleepiness Scale. Results are expressed as mean ± SD.
Figure 3
Figure 3
Comparison in terms of systolic blood pressure (SBP) between two groups. The follow-up period was 12 months. Results are expressed as mean ± SD.
Figure 4
Figure 4
Comparison in terms of diastolic blood pressure (DBP) between two groups. The follow-up period was 12 months. Results are expressed as mean ± SD.
Figure 5
Figure 5
Change in left ventricular ejection fraction (LVEF%) in patients with and without CPAP therapy. The follow-up period was 12 months.
Figure 6
Figure 6
Kaplan–Meier survival curves for patients with CPAP therapy and without CPAP therapy. CPAP—continuous positive airway pressure.
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