The Progression and Impact of Sleep Disordered Breathing in the Post-Discharge Phase of Acutely Decompensated Heart Failure

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2011-06

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The Ohio State University

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Abstract

Background: Sleep disordered breathing (SDB) is prevalent in more than half of patients with stable heart failure (HF). The Ohio State University Medical Center (OSUMC) Ross Heart Hospital has implemented a surveillance program to identify and treat sleep disordered breathing (SDB) in patients admitted with acutely decompensated heart failure (ADHF). Problem Statement: No studies have examined SDB following treatment during ADHF admission in-hospital to outcomes post-discharge. Purpose: To evaluate the effectiveness and feasibility of the in-hospital screening program at the Ross Hospital and evaluate the course of SDB post-discharge for admittance of ADHF. Methods: Subjects were obtained from an existing database of sleep study reports for ADHF admittance between May and September 2010. Patients were contacted by mail with a Minnesota Living with Heart Failure (MLWHF) questionnaire and a letter of instruction. All received a phone call inquiring about their follow-up status as well as an educational session about SDB and their heart condition. Patients were also asked to complete the questionnaire over the phone if they did not mail their responses. Results: 105 patients qualified for the in-hospital screening. 17 (16%) were negative for SDB and 88 (84%) were positive for SDB. Patients negative for SDB scored a MLWHF mean of 23.50 and patients positive for SDB had a mean score of 35.98. Of the 105 patients, 70 (67%) confirmation letters of SDB diagnosis were sent. In a separate cohort of 36 patients identified with CSA in-hospital, 26 of 36 (77%) identified with CSA on repeat studies post-discharge with optimal medical therapy. Conclusion: This study confirms the high prevalence of SDB in ADHF. While this study showed no significance in quality of life between SDB cohorts, the difference may be clinically significant for post-discharge outcomes. Screening has greater implications of expedited treatment of SDB during ADHF hospitalizations.

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Sleep Disordered Breathing, Heart Failure, OSA, CSA, Acutely Decompensated Heart Failure

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