PT - JOURNAL ARTICLE AU - Gian Domenico Pinna AU - Elena Robbi AU - Daniela Corbellini AU - Maria Teresa La Rovere AU - Roberto Maestri TI - Incidence and time of occurrence of arousals during Cheyne–Stokes respiration in heart failure patients AID - 10.1183/23120541.sleepandbreathing-2017.P91 DP - 2017 Apr 01 TA - ERJ Open Research PG - P91 VI - 3 IP - suppl 1 4099 - http://openres.ersjournals.com/content/3/suppl_1/P91.short 4100 - http://openres.ersjournals.com/content/3/suppl_1/P91.full SO - erjor2017 Apr 01; 3 AB - Background Arousals from sleep are thought to play an important role in sustaining Cheyne-Stokes respiration (CSR) in heart failure (HF) patients. Whether they represent a regular or occasional component of CSR and when they occur, however, have not yet been thoroughly investigated.Aims and objectives To determine the incidence and time of occurrence of arousals during CSR.Methods We studied 20 stable HF patients with reduced ejection fraction, an apnea-hypopnea index ≥15/h and dominant central sleep apnea. Arousal onset (ARon) was objectively determined using dedicated software. The analysis focused on all arousals at least partly concurrent with the hyperpneic phase of CS. Arousals were classified as “Early” (EA), if ARonoccurred before 3 s from hyperpnea onset; “Almost synchronous” (AS), if ARonoccurred between 3 s before hyperpnea onset and the end of the first post-apneic breath; “Late” (LA), if ARonoccurred after the first post-apneic breath.Results Incidence data (number of arousals /number of CSR cycles x 100) from the studied patients are given below (from 2048 CSR cycles): Mean±SDMin,MaxIncidence of EA arousals (%)2.8±2.70.0,9.3Incidence of AS arousals (%)20.5±10.82.6,42.5Incidence of LA arousals (%)50.5±16.130.9,79.2Total incidence (EA+AS+LA) (%)73.7±19.343.2,98.2Conclusions Although, on average, the great majority of CSR cycles are associated with an arousal, there are large differences between patients both in the total incidence and in the time of occurrence of arousals. These findings suggest that attempts at stabilizing breathing by pharmacological manipulation of the arousal threshold should be patient specific.