Prevalence of obstructive sleep apnea, associated risk factors, and quality of life among Indian congestive heart failure patients: a cross-sectional survey

J Cardiovasc Nurs. Nov-Dec 2011;26(6):452-9. doi: 10.1097/JCN.0b013e31820a048e.


Background and objectives: Stable congestive heart failure (CHF) patients frequently suffer from sleep apnea, which worsens the prognosis of heart failure and affects sleep quality of the patient. The present study was undertaken to assess the prevalence of obstructive sleep apnea (OSA) and associated quality of life (QOL) among CHF patients and to ascertain the relationship of OSA with excessive daytime sleepiness and selected demographic, clinical, and anthropometric characteristics.

Subjects and methods: Fifty CHF patients and 50 healthy controls were conveniently recruited at CHF clinic, cardiothoracic and neurosciences center outpatient department, All India Institute of Medical Sciences, New Delhi, India. Participants were interviewed using Epworth Sleepiness Scale, Modified Berlin Questionnaire, Kansas City Cardiomyopathy Questionnaire, and Quebec Sleep Questionnaire.

Results: The present study revealed 18% and 8% prevalence of OSA in the CHF and control groups, respectively. The prevalence of OSA was comparable in males and females. Excessive daytime sleepiness was significantly associated with OSA in CHF patients (P = .02). Clinical severity (New York Heart Association class) and duration of illness were not significantly associated with OSA. Increased body mass index and neck circumference were the significant risk factors responsible for OSA. Quality of life of CHF patients was poor, and OSA had a significantly negative impact on the already compromised QOL in CHF patients as well as in individuals with no CHF.

Conclusion: Prevalence of OSA is high in CHF patients as well as in the general population, and it has negative impact on the already compromised QOL of CHF patient; therefore, assessment of the risk of OSA and referral for appropriate treatment should be a part of routine nursing clinical workup. Nursing interventions should also be planned to improve sleep quality of CHF patients.

MeSH terms

  • Adult
  • Anthropometry
  • Body Mass Index
  • Case-Control Studies
  • Cross-Sectional Studies
  • Disorders of Excessive Somnolence / epidemiology
  • Female
  • Heart Failure / classification
  • Heart Failure / epidemiology*
  • Humans
  • India / epidemiology
  • Male
  • Neck / anatomy & histology
  • Prevalence
  • Quality of Life*
  • Risk Factors
  • Severity of Illness Index
  • Sleep Apnea, Obstructive / epidemiology*