Sleep disordered breathing in group 1 pulmonary arterial hypertension

Abstract

Study Objectives: To determine the prevalence and clinical predictors of sleep disordered breathing (SDB) and impact on outcomes in a cohort of patients with WHO group 1 pulmonary arterial hypertension (PAH). Methods: A retrospective, cross-sectional review of 52 consecutive subjects with known WHO group 1 PAH referred for assessment of possible SDB. Subjects had overnight polysomnography within 6 months of right heart catheterization performed as part of a routine clinical protocol. Results: SDB was present in 71% of the PAH patients: 56% had OSA and 44% CSA. Older age and subjective sleepiness as assessed by the Epworth Sleepiness Scale score > 10 were predictive of SDB. A high prevalence of OSA occurred in both male (50%) and female (60%) subjects. No differences in cardiopulmonary hemodynamics or survival between those with and without SDB were observed. Conclusions: This high prevalence of SDB in the PAH population suggests that systematic screening and testing is important in this group. Further studies are necessary to determine the pathophysiological effect of SDB and potential impact of SDB treatment in this population.