Chest
The Effect of Short-term Nasal CPAP on Cheyne-Stokes Respiration in Congestive Heart Failure
Section snippets
METHODS
We studied eight male patients who were not morbidly obese using the following inclusion criteria: younger than 65 years of age with a clinical diagnosis of stable severe CHF (NYHA class 3-4) and a measured left ventricular ejection fraction (LVEF) confirming reduced function (<50 percent). There was to be no evidence of neurologic disease, significant primary lung disease as assessed by history, lung function testing, and chest roentgenogram; no historic evidence of primary sleep disorders,
RESULTS
For complete anthropomorphic data see Table 1. Eight patients were studied. Their ages were 54.1 ± 8.9 years (mean ± SD) with a range of 41 to 65 years. One of the patients had a BMI over 30 and for the group mean BMI was 27.6 ±3.4 kg/m2. All the patients had clinical and radiologic evidence of CHF with an LVEF of 24.3 ± 11.5 percent. All patients had a congestive cardiomyopathy (seven were due to ischemic cardiomyopathy, one had an idiopathic cardiomyopathy) and had stable NYHA class 3 or 4
DISCUSSION
Cheyne-Stokes respiration, a complication of CHF,2,18 is also thought to be a poor prognostic indicator.2 It leads to sleep fragmentation and nocturnal O2 desaturation and can cause severe sleep disruption. This study confirms the previous findings of severe subjective and objective insomnia in severe CHF.3,19 It has been shown previously that CSR, sleep quality, and nocturnal SaO2 improve with O2 administration.11 The question we asked in this study was whether short-term NCPAP might also be
ACKNOWLEDGMENT
This work was supported by the Medical Research Council of Canada, the Heart ana Stroke Foundation of Canada, and the Manitoba Health Research Council. We also wish to thank Candace Harper for manuscript preparation.
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Manuscript received Augnst 19; revision accepted October