Sleep disordered breathing in older adults with heart failure with preserved ejection fraction.
Lynn M Baniak, Eileen R Chasens
PMID 28784337WHAT IT FOUND
Most small studies in older adults with HFpEF and sleep apnea linked positive airway pressure to better NYHA class and exercise function, but the evidence was low quality and a randomized trial was stopped early.
Key findings
01Positive airway pressure was associated with moderate to large improvements in NYHA functional class across four studies, with effect sizes ranging from -.67 to -1.6.
02The included studies had risks of bias, including non-experimental designs, small sample sizes, non-equivalent comparison groups, and 40% attrition.
03A randomized trial of ASV was terminated before the proposed 215 subjects were randomized, and preliminary data did not find that ASV improved cardiac status.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Most included studies were non-experimental or used non-equivalent comparison groups. Samples were small-to-modest convenience samples, and one study had 40% attrition. No study was a superiority randomized trial comparing different positive airway pressure devices. No study reported a power analysis except the terminated trial. Device adherence was often not reported, and average adherence was low in the terminated trial. Outcomes were mostly cardiac measures; patient-oriented outcomes were limited to NYHA class. The review could not access non-English, grey literature, or unpublished non-significant findings. HFpEF definitions varied across studies. The terminated randomized trial had only 126 of the proposed 215 participants randomized.
Declared interests
The authors declared no conflicts of interest. The article is listed as supported by NIH extramural research.
The easy way to misread this
Do not conclude that positive airway pressure is proven to improve cardiac outcomes in older adults with HFpEF. Most included studies were non-experimental or had non-equivalent comparison groups, and the randomized trial was terminated before its planned sample was reached.