Quality of Life in Chronic Heart Failure With Obstructive Sleep Apnea: A Systematic Review.
Francesco Limonti, Giovanni Cangelosi, Diaratou Dabre and 5 others
PMID 41313730WHAT IT FOUND
Sleep apnea is associated with worse quality of life in chronic heart failure.
CPAP may improve quality of life in obstructive sleep apnea, but adaptive servo-ventilation was associated with increased mortality in reduced ejection fraction, so use caution.
Key findings
01Sleep-disordered breathing was consistently associated with negative impacts on quality of life, functional capacity and cardiac function in patients with chronic heart failure.
02CPAP improved health-related quality of life domains and reduced daytime sleepiness in included trials.
03Adaptive servo-ventilation reduced apnea events but was associated with increased all-cause and cardiovascular mortality in patients with reduced ejection fraction and central sleep apnea.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review could not combine the studies into a single statistical result because designs, sample sizes, outcome measures and follow-up durations varied widely. The included studies were rated moderate to high quality, not all high. Only peer-reviewed English-language articles were included, so relevant studies in other languages may be missing. Most studies were done in Western countries and specialised clinical settings, so results may not apply in low-resource or non-specialist care. Long-term effectiveness was unclear because many studies had limited follow-up. Five full texts could not be obtained.
Declared interests
The authors report nothing to declare and declare no conflicts of interest.
The easy way to misread this
Do not conclude adaptive servo-ventilation is safe for all patients with heart failure and sleep apnea because smaller studies showed reduced apnea events and improved quality of life. The review reports increased all-cause and cardiovascular mortality with adaptive servo-ventilation in reduced ejection fraction and central sleep apnea.