Severe sleep apnea, Cheyne-Stokes respiration and desaturation in patients with decompensated heart failure at high altitude

Abstract

Objectives: To determine the sleep-disordered breathing in patients with decompensated HF (DHF) at an altitude of 2640m. Methods: Polysomnogram during the first 48 hours of admission in patients hospitalized for DHF. Sleep apnea (SA) was defined as an apnea hypopnea index (AHI) > 5/hour and central sleep apnea (CSA) as central apnea index (CAI) ≥ 50% of the AHI. Results: Sixteen participants, LVEF 24.2±9.9%. All patients had SA, severe in 12 (75%), CSA in 8 (50%) and 7 (43.8%) presented Cheyne-Stokes respiration (CSR). Out of the eight patients with obstructive SA, five had a central component (CAI ≥ 5/h). The SpO2 decreased during sleep to 80.6±5.5% and in patients with CSR to 77.6±6.9%. Conclusions: At an altitude of 2640m all patients with DHF presented sleep apnea, most were severe, with CSA and a significant percentage of CSR that was associated with higher oxygen desaturation.