CARDIOVASCULAR OUTCOMES AMONG ACUTE HEART FAILURE PATIENTS WITH NON-APNEA SLEEP DISORDERS

Abstract

Therapeutic Area: Heart Failure Background: Sleep is essential for overall health and well-being and is crucial in various physiological processes, including cardiovascular function. While obstructive sleep apnea (OSA) has been extensively studied for its detrimental effects on cardiovascular health, non-apnea sleeping disorders (NASD) have garnered less attention despite their potential impact. Among these disorders, such as insomnia, restless legs syndrome (RLS), and periodic limb movement disorder (PLMD), their association with Acute heart failure (AHF) outcomes remains an area of emerging interest and investigation. Methods: A retrospective cohort study was conducted using the National Inpatient Sample from 2016 to 2020. We included patients with documented non-apnea sleeping disorders among those with AHF, identified through validated ICD-10 codes. Univariate and multivariate logistic regression analyses identified outcomes and adjusted for potential confounders. Stata was used for the analysis. For all outcomes, standard adjustment and adjustment for the presence of OSA were applied. Results: Our study showed that 1,190,454 patients had acute heart failure (AHF). 1020 (0.086%) had non-apnea sleep disorder concurrent with AHF (NASD AHF). The mean age of NASD AHF patients was 68 years. The total charge for hospitalization in NASD AHF patients was $75,784, compared to $55,053 in patients without NASD AHF. The length of stay (LOS) for NASD AHF patients were 7 days on average. Regarding demographic characteristics, 75% of NASD AHF patients were White, and 53% were male.Regarding clinical outcomes, 5.9% of AHF NASD patients developed cardiogenic shock (aOR 1.88, 95% CI 1.055 - 3.35, p = 0.032), 14% developed heart block (aOR 1.67, 95% CI 1.13 - 2.48, p = 0.011), and 3.4% developed cardiac arrest (aOR 2.52, 95% CI 1.20 - 5.31, p = 0.015). Although, 7.8% of AHF NASD patients developed ventricular fibrillation (aOR 1.259634, p = 0.365, 95% CI 0.7641151 - 2.076492), and 46% developed atrial fibrillation (aOR 1.039379, p = 0.780, 95% CI 0.7928703 - 1.362528) these results were not statistically significant. Conclusions: Our study demonstrates that NASD in AHF patients increases the risk of adverse cardiac events like cardiac arrest, cardiogenic shock, and heart block. Recognizing and managing NASD in AHF is crucial for improving outcomes and reducing healthcare costs.