Sleep Disordered Breathing in Heart Failure

Background: Sleep-disordered breathing (SDB) is a common but underdiagnosed comorbidity in patients with chronic heart failure (CHF), potentially affecting up to 70–80% of this population. The aim of this study was to assess the frequency and characteristics of SDB among CHF patients and to compare sleep parameters between sleepier and less sleepy individuals based on the Epworth Sleepiness Scale (ESS). Methods: This cross-sectional observational study was conducted in the Departments of Cardiology and Respiratory Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from July 2022 to June 2023. Ninety-six stable CHF patients aged 18 to 75 years with elevated BNP levels and confirmed left ventricular systolic dysfunction (EF ≤ 40% or preserved) by echocardiography were enrolled. Results: The mean age of the participants was 56 ± 4.5 years; 63% were male. The mean EF was 38.5%, with 65.7% having reduced EF. The average total sleep time was 348 ± 74 minutes in Group A and 270 ± 79 minutes in Group B. The apnea-hypopnea index (AHI) was significantly higher in Group B (31 ± 14) compared to Group A (18 ± 13), suggesting more severe SDB in less sleepy patients. Arousal index and REM sleep percentages were comparable between groups. Although the frequency of OSA and CSA did not differ significantly between groups, less sleepy patients had higher AHI values, which may be linked to increased mortality risk. Conclusion: SDB is highly prevalent among CHF patients, with both OSA and CSA commonly observed. Interestingly, less sleepy CHF patients demonstrated more severe SDB, highlighting the importance of screening even in the absence of excessive daytime sleepiness.