sleep

HIV, Heart Failure Increase the Risk for Sleep Apnea

Individuals with HIV and heart failure (HF) have a higher risk for sleep apnea, according to findings from a new study.

The researchers came to this conclusion after analyzing data from 1124 individuals admitted to the hospital with a diagnosis of HF with reduced ejection fraction (HFrEF), which was defined as a left ventricular ejection fraction of less than 50%. They then analyzed the 30-day readmission rate for HF to determine the association of sleep apnea.

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Initial analysis showed that 15% of individuals admitted with HFrEF were HIV-positive, 92% of whom were on antiretroviral therapy.

About 28% of those with HIV and 26% of those without HIV were affected by sleep apnea.

The researchers were able to identify a few predictors for obstructive sleep apnea—vs central sleep apnea—in individuals with HIV and HFrEF, including:

  • Lower body mass index,
  • Lower left ventricular ejection fraction, and
  • Higher pulmonary artery systolic pressure.

Moreover, the researchers found that pulmonary artery systolic pressure, low CD4 count, high viral load, and sleep apnea parameters such as CPAP use and duration were predictors for 30-day readmission rate.

“Compared [with] uninfected controls, [persons living with HIV] were more likely to have obstructive [sleep apnea] than central [sleep apnea],” the researchers wrote. “Apnea severity, low CD4 count, high [viral load], and cocaine use were positively associated with 30-day HF hospital readmission rate, whereas CPAP use and increased duration of CPAP use conferred protection.”

—Amanda Balbi

Reference:

Alvi RM, Tariq N, Malhotra A, et al. Sleep apnea and heart failure with a reduced ejection fraction among persons living with human immunodeficiency virus. Clin Infect Dis. 2018;67(3):447-455. https://doi.org/10.1093/cid/ciy216.

 

 

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