Incident Cheyne-Stokes respiration occurring in CPAP-treated patients and cardiovascular risk: a 2-years prospective follow-up (The Alertapnee study)

Abstract The Alertapnée study followed 555 adults with obstructive sleep apnea treated with CPAP and found that the occurrence of Cheyne-Stokes respiration (CSR) was linked to a 14-fold increase in the risk of significant cardiac events (SCE) after one year. However, the progression and clinical sig...

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Main Authors: Arnaud Prigent, Joëlle Texereau, Sébastien Bailly, Renaud Gervais, Anne-Laure Serandour, Régis Luraine, Jean Louis Pépin
Format: Article
Language:English
Published: BMC 2025-01-01
Series:Respiratory Research
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Online Access:https://doi.org/10.1186/s12931-025-03109-9
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author Arnaud Prigent
Joëlle Texereau
Sébastien Bailly
Renaud Gervais
Anne-Laure Serandour
Régis Luraine
Jean Louis Pépin
author_facet Arnaud Prigent
Joëlle Texereau
Sébastien Bailly
Renaud Gervais
Anne-Laure Serandour
Régis Luraine
Jean Louis Pépin
author_sort Arnaud Prigent
collection DOAJ
description Abstract The Alertapnée study followed 555 adults with obstructive sleep apnea treated with CPAP and found that the occurrence of Cheyne-Stokes respiration (CSR) was linked to a 14-fold increase in the risk of significant cardiac events (SCE) after one year. However, the progression and clinical significance of CSR episodes over time remain unclear. This ancillary study aimed to assess CSR progression and clinical outcomes during a second year of follow-up in 66 patients who had experienced at least one CSR episode in the first year. The study focused on the number of nights with CSR, percentage of CSR, SCEs. Results showed that 62 of 66 patients with CSR in the first year also experienced CSR in the second year, with a significant increase in the median number of CSR nights, particularly when CSR was related to cardiovascular conditions (37 vs. 19 nights, p = 0.006). Patients who experienced a SCE in year 2 had significantly more nights with CSR (median 48/90nights; IQR = 35) and a significantly greater mean percentage of CSR (median 13.8%; interquartile range (IQR) = 13.7) as compared with patients free of SCE (median 9.5/90 nights IQR = 27.8 (p = 0.012); 6.1% IQR = 4.5 (p = 0.008), respectively). In conclusion, CSR occurrence and severity depend on the underlying condition. CSR related to cardiovascular aetiology increases over time and is associated with SCEs, whereas CSR linked to non-cardiovascular conditions does not indicate a poor prognosis. Identifying CSR patterns related to cardiovascular aetiologies could enable early detection of SCEs through telemonitoring in CPAP-treated patients.
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spelling doaj-art-61b762ea8e94488bb3a5249226c669cb2025-01-26T12:48:59ZengBMCRespiratory Research1465-993X2025-01-012611710.1186/s12931-025-03109-9Incident Cheyne-Stokes respiration occurring in CPAP-treated patients and cardiovascular risk: a 2-years prospective follow-up (The Alertapnee study)Arnaud Prigent0Joëlle Texereau1Sébastien Bailly2Renaud Gervais3Anne-Laure Serandour4Régis Luraine5Jean Louis Pépin6Groupe Medical de Pneumologie, Polyclinique Saint-LaurentCochin University Hospital, Assistance Publique – Hôpitaux de ParisHP2 Laboratory, Inserm Unit 1300, University Grenoble AlpesService de cardiologie, Polyclinique Saint LaurentSLB PharmaGroupe Medical de Pneumologie, Polyclinique Saint-LaurentHP2 Laboratory, Inserm Unit 1300, University Grenoble AlpesAbstract The Alertapnée study followed 555 adults with obstructive sleep apnea treated with CPAP and found that the occurrence of Cheyne-Stokes respiration (CSR) was linked to a 14-fold increase in the risk of significant cardiac events (SCE) after one year. However, the progression and clinical significance of CSR episodes over time remain unclear. This ancillary study aimed to assess CSR progression and clinical outcomes during a second year of follow-up in 66 patients who had experienced at least one CSR episode in the first year. The study focused on the number of nights with CSR, percentage of CSR, SCEs. Results showed that 62 of 66 patients with CSR in the first year also experienced CSR in the second year, with a significant increase in the median number of CSR nights, particularly when CSR was related to cardiovascular conditions (37 vs. 19 nights, p = 0.006). Patients who experienced a SCE in year 2 had significantly more nights with CSR (median 48/90nights; IQR = 35) and a significantly greater mean percentage of CSR (median 13.8%; interquartile range (IQR) = 13.7) as compared with patients free of SCE (median 9.5/90 nights IQR = 27.8 (p = 0.012); 6.1% IQR = 4.5 (p = 0.008), respectively). In conclusion, CSR occurrence and severity depend on the underlying condition. CSR related to cardiovascular aetiology increases over time and is associated with SCEs, whereas CSR linked to non-cardiovascular conditions does not indicate a poor prognosis. Identifying CSR patterns related to cardiovascular aetiologies could enable early detection of SCEs through telemonitoring in CPAP-treated patients.https://doi.org/10.1186/s12931-025-03109-9Cardiac eventCentral sleep apnoeaCheyne–stokes respirationChronic heart failureContinuous positive airway pressureCPAP
spellingShingle Arnaud Prigent
Joëlle Texereau
Sébastien Bailly
Renaud Gervais
Anne-Laure Serandour
Régis Luraine
Jean Louis Pépin
Incident Cheyne-Stokes respiration occurring in CPAP-treated patients and cardiovascular risk: a 2-years prospective follow-up (The Alertapnee study)
Respiratory Research
Cardiac event
Central sleep apnoea
Cheyne–stokes respiration
Chronic heart failure
Continuous positive airway pressure
CPAP
title Incident Cheyne-Stokes respiration occurring in CPAP-treated patients and cardiovascular risk: a 2-years prospective follow-up (The Alertapnee study)
title_full Incident Cheyne-Stokes respiration occurring in CPAP-treated patients and cardiovascular risk: a 2-years prospective follow-up (The Alertapnee study)
title_fullStr Incident Cheyne-Stokes respiration occurring in CPAP-treated patients and cardiovascular risk: a 2-years prospective follow-up (The Alertapnee study)
title_full_unstemmed Incident Cheyne-Stokes respiration occurring in CPAP-treated patients and cardiovascular risk: a 2-years prospective follow-up (The Alertapnee study)
title_short Incident Cheyne-Stokes respiration occurring in CPAP-treated patients and cardiovascular risk: a 2-years prospective follow-up (The Alertapnee study)
title_sort incident cheyne stokes respiration occurring in cpap treated patients and cardiovascular risk a 2 years prospective follow up the alertapnee study
topic Cardiac event
Central sleep apnoea
Cheyne–stokes respiration
Chronic heart failure
Continuous positive airway pressure
CPAP
url https://doi.org/10.1186/s12931-025-03109-9
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