Chest
Clinical InvestigationsRespiration and Abnormal Sleep in Patients with Congestive Heart Failure
Section snippets
METHODS
Ten male patients were investigated from March 1987 to April 1988. All patients were referred by the cardiology service which had been informed of our study protocol. Inclusion criteria for participation in the study were as follow: (1) male patients less than 70 years old with a clinical diagnosis of significant, stable congestive heart failure (New York Heart Association class 3 or 4); (2) left ventricular ejection fraction <35 percent; (3) no evidence of neurologic disease, significant
RESULTS
Ten patients aged 40 to 66 years were studied (Table 1). None was morbidly obese. All had congestive heart failure which was due to ischemic cardiomyopathy in nine patients and alcoholic cardiomyopathy in one. Two patients had chronic atrial fibrillation and two had a permanent pacemaker in situ. Although their congestive cardiac failure was clinically stable (all were ambulatory outpatients), it was nevertheless severe as evidenced by New York Heart Association classification 3 to 4 and the
DISCUSSION
We found that sleep structure was grossly abnormal in heart failure. This study describes the role of sleep and arousal state in congestive heart failure with particular regard to the distribution of CSR during sleep and the interaction between CSR, arterial oxygen saturation and sleep architecture. Cheyne-Stokes respiration was found in all patients and occurred predominantly during stage 1 and 2 NREM sleep. Arterial oxygenation was normal during wakefulness, although awake breathing pattern
ACKNOWLEDGMENTS:
We are grateful to Ms Zoe Pouliot for typing the manuscript.
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Supported by Canadian Heart Association and St. Boniface General Hospital Research Foundation.
Manuscript received December 2; revision accepted February 1.