0654 Sleep Apnea in Hospitalized Patients with Systolic Heart Failure (SLEEP-HEART STUDY)

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Abstract Introduction Sleep disordered breathing(SDB) is common in patients with heart failure(CHF) and is subtyped into obstructive (OSA) and central sleep apnea(CSA). Based on prior studies,CSA occurs in 25-40% of patients with CHF with reduced ejection fraction (HFrEF). With the implementation of quadruple therapy for management of HFrEF in the recent years, we aim to understand the current prevalence of CSA in our hospitalized patients both with stable and decompensated HFrEF as well as compare outcomes data. Methods Through a retrospective review of patients from 09/2019-12/2023 in a hospital-based sleep medicine program registry. patients admitted with a history of HFrEF, who underwent inpatient Apnea link followed by outpatient polysomnography (PSG) were reviewed. Patients were subdivided into those admitted with stable HFrEF and decompensated HFrEF. Data on in-hospital AHI, time spent< 88% (T88), PSG AHI, sleep apnea type, medications and outcomes data were compared. Results Of the 77 HFrEF pts on whom complete data on inpatient screening and post-discharge PSG was available, 50 had decompensated and 27 were stable HFrEF. Mean BMI was 35.3 ±11.8 vs 35.2 ± 9.2 while mean EF was 27 ± 11 vs 32.5 ± 9.7. Interestingly, apnea link AHI was lower in the decompensated group compared to the outpatient PSG AHI (27.6 ±18.4 vs 34.5 ±27.5) though it was the opposite for stable HFrEF (34.5 ±26.7 vs 23 ±21.65). T88 was 76.3 ± 91.8 vs 73.6 ±109.3 min in decompensated patients and 65.9 ± 78.5 vs 59.5 ± 97.5 min in stable patients, with the former group desaturating more. The prevalence of CSA was notably low (6%,11%) with predominance of OSA (68% and 55%), mixed sleep apnea(8% and 11%). Quadruple therapy was prescribed more in the decompensated group, which also had higher 180-day ED and hospital readmissions (21/30 and 26/31) and mortality (12/50 vs 3/27). Conclusion The incidence of CSA for HFrEF was significantly lower compared to prior studies in ambulatory settings. This could be due to availability of better therapy. The decompensated group was observed to have worse AHI on PSG than with in-hospital portable sleep study as well as high 180-day ED and hospital re-admission and mortality. Support (if any)

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