Prevalence of obstructive steep apnoea and periodic limb movement in 45 subjects with heart transplantation

Background Obesity, a major risk factor for obstructive steep apnoea, is common after cardiac transplantation. Case reports have shown development of obstructive steep apnoea in cardiac transplantation recipients. The present study represents the first systematic evaluation of steep disorders after cardiac transplantation. Objective To determine the prevalence and clinical impact of steep disorders in a cohort of cardiac transplant recipients. Methods This was a cross-sectional study at the Veterans Affairs Medical Center. Forty-five of 60 eligible subjects agreed to take part in the study. Potysomnography, steep and health survey questionnaires, and laboratory tests were recorded. Results Thirty-six percent had obstructive steep apnoea-hypopnoea with an index of 15 or more per hour. The average apnoea-hypopnoea index was about 50+/-27 (SD) per hour. Steep apnoea resulted in arterial oxyhaemoglobin desaturation, excessive arousals, unrefreshing steep, excessive daytime sleepiness, poor health-related quality of life, and hypertension (all P values <0.05). Weight gain since transplantation was significantly greater in recipients with obstructive steep apnoea than those without. Thirty-three percent of patients had periodic limb movement with an index of 15/hour and an average of 55+/-43/hour. Forty-five percent of these patients had restless legs syndrome. Conclusion Thirty-six percent of cardiac transplant recipients have moderate to severe obstructive steep apnoea. Steep apnoea results in disrupted steep, desaturation and impaired quality of life. Potysomnography should be routinely considered in the ongoing management of most cardiac transplant recipients. Treatment of obstructive steep apnoea may improve quality of life and other outcomes of cardiac transplantation. (C) 2003 Published by Elsevier Ltd on behalf of The European Society of Cardiology.