Risk factors for, and prevalence of, sleep apnoea in cardiac rehabilitation facilities in Germany: The Reha-Sleep registry

Skobel, Erik; Kamke, Wolfram; Bönner, Gerd; Purucker, Hans-Christian; Schwaab, Bernhard; Einwang, Hans-Peter; Schröder, Klaus; Langheim, Eike; Völler, Heinz; Brandenburg, Alexandra; Graml, Andrea; Woehrle, Holger; Krüger, Stefan

doi:10.1177/2047487314537916

Cited by 16 publications

(12 citation statements)

References 78 publications

(101 reference statements)

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“…Our analyses indicated that the presence of a sleep disturbance at 4 months, however, could have a potential detrimental effect on cardiac rehabilitation efforts via reduction of treatment adherence, lower self-efficacy, and increased depression and anxiety. It is already known that cardiac patients with sleep disturbances have daytime sleepiness, fatigue and, as a result, reduced physical activity and find it more difficult to lose weight than those without a sleep disorder (Skobel et al, 2014). Our analysis which controlled for age, sex and type of cardiac patient (CABGS, AMI or PCI) suggests that these pathways resulting from earlier sleep disturbance may potentially result in lower patient self-efficacy and increased risk of further heart problems at 12 months following the initial cardiac event.…”

Section: Discussionmentioning

confidence: 99%

Relationship between sleep disturbance, depression and anxiety in the 12 months following a cardiac event

Grande

Jackson

Murphy

et al. 2015

Psychology, Health & Medicine

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We aimed to assess the prevalence of sleep disturbance in a cardiac patient population over a 12-month period and assess its relationship with treatment adherence, self-efficacy, anxiety and depression. A total of 134 patients consecutively admitted to two Australian hospitals after acute myocardial infarction (31%), or to undergo bypass surgery (29%) or percutaneous coronary intervention (40%) were interviewed at six weeks and four and 12 months. Sleep disturbance was measured using a recode of the Beck Depression Inventory (v.2) item 16. Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale. Sleep disturbance was highly prevalent (69%) at 6 weeks but was not associated with 12-month psychological outcomes. Path analysis revealed that sleep disturbance at 4 months was, however, associated with reduced treatment adherence and self-efficacy, and higher anxiety and depression scores at 12 months. The high prevalence of sleep disturbance in this study and its association with psychological outcomes may have adverse prognostic implications and possibly impede cardiac rehabilitation efforts.

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Section: Discussionmentioning

confidence: 99%

Relationship between sleep disturbance, depression and anxiety in the 12 months following a cardiac event

Grande

Jackson

Murphy

et al. 2015

Psychology, Health & Medicine

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“… 18 Recently published data from the Reha-Sleep registry, investigating the prevalence of SDB in cardiac rehabilitation patients, reported that clinically significant SA (AHI ≥15/h) was documented in 33% of patients. 19 Applying a cut-off level of an AHI of 15, the SA prevalence in our study was 14% (16.4% in men, 6.5% in women). Our study, using a cross-sectional design, is fraught with problems of uncertainty, bias and confounding.…”

Section: Discussionmentioning

confidence: 56%

Prevalence and predictors of sleep apnea in patients with stable coronary artery disease: a cross-sectional study

Alonderis¹,

Varoneckas²,

Raškauskienė³

et al. 2017

TCRM

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BackgroundSleep apnea (SA) is increasingly recognized as being important in the prognosis of patients with coronary artery disease (CAD); however, symptoms of SA are not easily identified, and as many as 80% of sufferers remain undiagnosed.AimThis cross-sectional study investigated the prevalence and predictors of SA that may help to increase the awareness and diagnosis of SA in stable CAD patients.Materials and methodsPolysomnography was performed in 772 medically stable CAD patients with untreated SA recruited from the Clinic of Cardiovascular Rehabilitation. Patients were predominantly male (76%), median age was 58 years (32–81). All subjects completed the Epworth sleepiness scale (ESS). The frequency of all apneas and hypopneas associated with 3% oxygen desaturation is referred to as the apnea–hypopnea index (AHI). Mild-to-severe SA was defined as AHI ≥5/h, moderate-to-severe SA as AHI ≥15/h.ResultsAHI was within a range of values that was considered normal or only mildly elevated. The median AHI was 3.4 (interquartile range [IQR 1–9]), and 39% of patients had unrecognized mild-to-severe SA (moderate-to-severe in 14%), which was not higher than other known risk indicators for CAD such as hypertension and obesity (83% and 47%, respectively). These patients did not show sleepiness and the risk-related cut-off score for excessive daily sleepiness was lower than the official for ESS.ConclusionHypertension, age, male gender, obesity, ESS ≥6, and left ventricular ejection fraction ≤45% were the best predictors of mild-to-severe SA. While, male gender, age 50–70 years and, mainly, the presence of obesity but not hypertension were clinical predictors for moderate-to-severe SA. In addition, association between mild-to-severe SA and obesity was not evident in women. SA is prevalent comorbidity in the stable CAD patients, especially in its asymptomatic mild form. We suggest that SA should be considered in the secondary prevention protocols for CAD.

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“…In 3 other studies, the proportion of patients enrolled in CRPs with a previous diagnosis of OSA was 1.8% (n = 22/1293), 26 3.9% (n = 15/383), 25 and 17% (n = 20/118). Education and communication with the patient and physician resulted in 3 of the 7 patients (42.9%) who responded to the 6-month questionnaire and had a conversation with their physician resuming CPAP treatment.…”

Section: Discussionmentioning

confidence: 87%

Utility of Screening for Obstructive Sleep Apnea in Cardiac Rehabilitation

Marzolini

Sarin²,

Reitav³

et al. 2016

Journal of Cardiopulmonary Rehabilitation and Prevention

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Risk factors for, and prevalence of, sleep apnoea in cardiac rehabilitation facilities in Germany: The Reha-Sleep registry

Cited by 16 publications

References 78 publications

Relationship between sleep disturbance, depression and anxiety in the 12 months following a cardiac event

Relationship between sleep disturbance, depression and anxiety in the 12 months following a cardiac event

Prevalence and predictors of sleep apnea in patients with stable coronary artery disease: a cross-sectional study

Utility of Screening for Obstructive Sleep Apnea in Cardiac Rehabilitation

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