Quality of life in patients with congestive heart failure and central sleep apnea

OBJECTIVE: To assess the impact of Cheyne-Stoke respiration-central sleep apnea (CSR-CSA) on quality of life (QOL) in patients with congestive heart failure (CHF). QOL was established using the MLHFQ (Minnesota Living with Heart Failure Questionnaire), and the FOSQ (Functional Outcomes of Sleep Questionnaire).

METHODS: We examined 90 patients with CHF. The diagnosis of CSR-CSA was performed by polysomnography. We established a correlation between the apnea-hypopnea index (AHI) and the MLHFQ and FOSQ scores.

RESULTS: Five patients were excluded (obstructive sleep apnea). Of the 85 remaining patients, 25 presented CSR-CSA. The mean MLHFQ score was higher in patients with CHF and CSR-CSA (25.8+/-2.97 vs. 16.6+/-2.05; p=0.01), and showed a significant yet moderate correlation with the AHI. A lower mean FOSQ score was obtained for the group of patients with CHF and CSR-CSA (78.4+/-4.31 vs. 88.47+/-2.4; p=0.03), showing weak negative correlation with the AHI.

CONCLUSION: According to the MLHFQ scores, it seems that CHF patients with CSR-CSA have a worse QOL than those with CHF alone. Although this could be attributable to a greater impairment of heart function in the former group, the FOSQ scores indicate some influence of their sleep disorder on the impairment of QOL.