Key result
Central sleep apnea in acute heart failure patients was associated with significantly lower quality of life (KCCQ 37.18 vs 61.12) and more severe depression than obstructive sleep apnea (p<0.001).
Why the study?
Managing acute decompensated heart failure is complex with comorbidities like sleep apnea, requiring personalized approaches focusing on quality of life and mental health outcomes.
Does the sleep apnea phenotype (obstructive vs. central) impact quality of life and mental health in patients with acute heart failure exacerbations?
Cohort (n=150)
Does the sleep apnea phenotype (obstructive vs. central) impact quality of life and mental health in patients with acute heart failure exacerbations?
In patients with acute heart failure exacerbations and sleep apnea, the central sleep apnea phenotype is associated with significantly worse quality of life and more severe depression compared to obstructive sleep apnea.
CSA phenotype merits attention in acute HF QoL assessment; leaves open causal inference and targeted intervention trials.
Background: Managing acute decompensated heart failure (ADHF) is complex, particularly when combined with comorbidities like sleep apnea. Effective treatment requires personalized approaches, focusing on quality of life (QoL) and mental health outcomes. Purpose: This study explored the prevalence and characteristics of sleep apnea in patients with obesity and AHF exacerbations. It assessed how different sleep apnea phenotypes impact QoL and mental health, applying personalized medicine strategies. Methods: A prospective cohort study was conducted on 150 patients admitted for AHF exacerbation. Inclusion criteria included an Apnea–Hypopnea Index (AHI) > 5, an Epworth Sleepiness Scale (ESS) > 8, NT-proBNP > 900 pg/mL and informed consent obtained prior to participation. Optimized medical treatment was provided. QoL and mental health were evaluated using the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the Beck Depression Inventory (BDI). Results: Among 81 patients with sleep apnea, 73% (n = 59) had obstructive sleep apnea (OSA) and 27% (n = 19) had central sleep apnea (CSA). OSA patients reported a higher QoL (61.12 ± 17.88) compared to CSA patients (37.18 ± 19.98, p < 0.001). CSA patients exhibited more severe depression (BDI: 26.18 ± 5.5 vs. 16.64 ± 4.1, p < 0.001). Significant correlations were noted between KCCQ and BDI scores (r = −0.849, p < 0.001) and central apnea events (r = −0.485, p < 0.001). Conclusions: Sleep apnea is common in ADHF patients, with CSA being linked to poorer QoL and greater depression. Personalized medicine offers promising strategies to enhance care and outcomes.
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Kalaydzhiev et al. (2025) conducted a cohort in Acute decompensated heart failure with sleep apnea (n=150). Obstructive sleep apnea (OSA) vs. Central sleep apnea (CSA) was evaluated on Quality of life (KCCQ score) (p=<0.001). Central sleep apnea in acute heart failure patients was associated with significantly lower quality of life (KCCQ 37.18 vs 61.12) and more severe depression than obstructive sleep apnea (p<0.001).
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