Journal Article

Effect of oxygen on sleep quality, cognitive function and sympathetic activity in patients with chronic heart failure and Cheyne–Stokes respiration

A.D. Staniforth, W.J.M. Kinnear, R. Starling, D.J. Hetmanski and A.J. Cowley

in European Heart Journal

Published on behalf of European Society of Cardiology

Volume 19, issue 6, pages 922-928
Published in print June 1998 | ISSN: 0195-668x
Published online June 1998 | e-ISSN: 1522-9645 | DOI: http://dx.doi.org/10.1053/euhj.1997.0861
Effect of oxygen on sleep quality, cognitive function and sympathetic activity in patients with chronic heart failure and Cheyne–Stokes respiration

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Background

Cheyne–Stokes respiration disrupts sleep, leading to daytime somnolence and cognitive impairment. It is also an independent marker of increased mortality in heart failure. This study evaluated the effectiveness of oxygen therapy for Cheyne–Stokes respiration in heart failure.

Methods

Eleven patients with stable heart failure and Cheyne–Stokes breathing were studied. Oxygen and air were administered for 4 weeks in a double-blind, cross-over study. Sleep and disordered breathing was assessed by polysomnography. Symptoms were assessed using the Epworth Sleepiness Scale, visual analogue and quality of life scores. Cognitive function was assessed by neuro-psychometric testing. Overnight urinary catecholamine excretion was used as a measure of sympathetic nerve activity.

Results

Ninety-seven percent of apnoeas were central in origin. Oxygen therapy reduced the central apnoea rate (18·4±4·1 vs 3·8±2·1 per hour;P=0·05) and periodic breathing time (33·6±7·4 vs 10·7±3·9% of actual sleep time;P=0·003). Oxygen did not improve sleep quality, patient symptoms or cognitive failure. Oxygen reduced urinary noradrenaline excretion (8·3±1·5 vs 4·1±0·6nmol.mmol−1urinary creatinine;P=0·03).

Conclusion

Oxygen stabilized sleep disordered breathing and reduced sympathetic activity in patients with heart failure and Cheyne–Stokes respiration. We were unable to demonstrate an effect on either patient symptoms or cognitive function.

Keywords: heart failure; Cheyne–Stokes respiration; oxygen; sympathetic activity

Journal Article.  19 words. 

Subjects: Cardiovascular Medicine

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