Clinical Research
Heart Failure
Relationship Between Sodium Intake and Sleep Apnea in Patients With Heart Failure

https://doi.org/10.1016/j.jacc.2011.08.012Get rights and content
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Objectives

The purpose of this study was to test the hypothesis that severity of sleep apnea (SA), assessed by frequency of apneas and hypopneas per hour of sleep (apnea-hypopnea index [AHI]), is related to sodium intake in patients with heart failure (HF).

Background

Dependent edema and overnight rostral fluid shift from the legs correlate with the AHI in patients with HF in whom excessive sodium intake can cause fluid retention.

Methods

Sodium intake was estimated by food recordings in 54 HF patients who underwent overnight polysomnography.

Results

Thirty-one of the 54 patients had SA, and their mean sodium intake was higher than that in those without SA (3.0 ± 1.2 g vs. 1.9 ± 0.8 g, p < 0.001). There was a significant correlation between the AHI and sodium intake (r = 0.522, p < 0.001). Multivariate analysis showed that the significant independent correlates of the AHI were sodium intake, male sex, and serum creatinine level.

Conclusions

These findings suggest that in patients with HF, sodium intake plays a role in the pathogenesis of SA.

Key Words

diet
fluid
food record
renal dysfunction
volume overload

Abbreviations and Acronyms

AHI
apnea-hypopnea index
BMI
body mass index
CPAP
continuous positive airway pressure
CSA
central sleep apnea
eGFR
estimated glomerular filtration rate
HF
heart failure
LVEF
left ventricular ejection fraction
OSA
obstructive sleep apnea
SA
sleep apnea

Cited by (0)

This study was supported by the Canadian Institutes of Health Research operating grant MOP-82731 and Heart and Stroke Foundation of Ontario operating grant NA-5897. Dr. Kasai was supported by an unrestricted research fellowship from Fuji-Respironics Inc. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Drs. Kasai and Arcand contributed equally to this work.