Quality of Life and Mental Health in Patients with Exacerbated Heart Failure: The Role of Obstructive and Central Sleep Apnea Phenotypes

<b>Background</b>: Managing acute decompensated heart failure (ADHF) is complex, particularly when combined with comorbidities like sleep apnea. Effective treatment requires personalized approaches, focusing on quality of life (QoL) and mental health outcomes. <b>Purpose</b>:...

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Main Authors: Petar Kalaydzhiev, Tsvetelina Velikova, Gergana Voynova, Desislava Somleva, Natalia Spasova, Radostina Ilieva, Elena Kinova, Assen Goudev
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Journal of Mind and Medical Sciences
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Online Access:https://www.mdpi.com/2392-7674/12/1/18
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author Petar Kalaydzhiev
Tsvetelina Velikova
Gergana Voynova
Desislava Somleva
Natalia Spasova
Radostina Ilieva
Elena Kinova
Assen Goudev
author_facet Petar Kalaydzhiev
Tsvetelina Velikova
Gergana Voynova
Desislava Somleva
Natalia Spasova
Radostina Ilieva
Elena Kinova
Assen Goudev
author_sort Petar Kalaydzhiev
collection DOAJ
description <b>Background</b>: Managing acute decompensated heart failure (ADHF) is complex, particularly when combined with comorbidities like sleep apnea. Effective treatment requires personalized approaches, focusing on quality of life (QoL) and mental health outcomes. <b>Purpose</b>: This study explored the prevalence and characteristics of sleep apnea in patients with obesity and AHF exacerbations. It assessed how different sleep apnea phenotypes impact QoL and mental health, applying personalized medicine strategies. <b>Methods</b>: A prospective cohort study was conducted on 150 patients admitted for AHF exacerbation. Inclusion criteria included an Apnea–Hypopnea Index (AHI) > 5, an Epworth Sleepiness Scale (ESS) > 8, NT-proBNP > 900 pg/mL and informed consent obtained prior to participation. Optimized medical treatment was provided. QoL and mental health were evaluated using the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the Beck Depression Inventory (BDI). <b>Results</b>: Among 81 patients with sleep apnea, 73% (<i>n</i> = 59) had obstructive sleep apnea (OSA) and 27% (<i>n</i> = 19) had central sleep apnea (CSA). OSA patients reported a higher QoL (61.12 ± 17.88) compared to CSA patients (37.18 ± 19.98, <i>p</i> < 0.001). CSA patients exhibited more severe depression (BDI: 26.18 ± 5.5 vs. 16.64 ± 4.1, <i>p</i> < 0.001). Significant correlations were noted between KCCQ and BDI scores (<i>r</i> = −0.849, <i>p</i> < 0.001) and central apnea events (<i>r</i> = −0.485, <i>p</i> < 0.001). <b>Conclusions</b>: Sleep apnea is common in ADHF patients, with CSA being linked to poorer QoL and greater depression. Personalized medicine offers promising strategies to enhance care and outcomes.
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spelling doaj-art-8f6d8d0ad72142fda0d4283b2cfb8e6c2025-08-20T03:27:14ZengMDPI AGJournal of Mind and Medical Sciences2392-76742025-04-011211810.3390/jmms12010018Quality of Life and Mental Health in Patients with Exacerbated Heart Failure: The Role of Obstructive and Central Sleep Apnea PhenotypesPetar Kalaydzhiev0Tsvetelina Velikova1Gergana Voynova2Desislava Somleva3Natalia Spasova4Radostina Ilieva5Elena Kinova6Assen Goudev7Department of Emergency Medicine, Medical University—Sofia, 1000 Sofia, BulgariaMedical Faculty, Sofia University St. Kliment Ohridski, Sofia 1407, BulgariaCardiology Department, University Hospital “Tsaritsa Yoanna—ISUL”, 1000 Sofia, BulgariaDepartment of Emergency Medicine, Medical University—Sofia, 1000 Sofia, BulgariaDepartment of Emergency Medicine, Medical University—Sofia, 1000 Sofia, BulgariaDepartment of Emergency Medicine, Medical University—Sofia, 1000 Sofia, BulgariaDepartment of Emergency Medicine, Medical University—Sofia, 1000 Sofia, BulgariaDepartment of Emergency Medicine, Medical University—Sofia, 1000 Sofia, Bulgaria<b>Background</b>: Managing acute decompensated heart failure (ADHF) is complex, particularly when combined with comorbidities like sleep apnea. Effective treatment requires personalized approaches, focusing on quality of life (QoL) and mental health outcomes. <b>Purpose</b>: This study explored the prevalence and characteristics of sleep apnea in patients with obesity and AHF exacerbations. It assessed how different sleep apnea phenotypes impact QoL and mental health, applying personalized medicine strategies. <b>Methods</b>: A prospective cohort study was conducted on 150 patients admitted for AHF exacerbation. Inclusion criteria included an Apnea–Hypopnea Index (AHI) > 5, an Epworth Sleepiness Scale (ESS) > 8, NT-proBNP > 900 pg/mL and informed consent obtained prior to participation. Optimized medical treatment was provided. QoL and mental health were evaluated using the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the Beck Depression Inventory (BDI). <b>Results</b>: Among 81 patients with sleep apnea, 73% (<i>n</i> = 59) had obstructive sleep apnea (OSA) and 27% (<i>n</i> = 19) had central sleep apnea (CSA). OSA patients reported a higher QoL (61.12 ± 17.88) compared to CSA patients (37.18 ± 19.98, <i>p</i> < 0.001). CSA patients exhibited more severe depression (BDI: 26.18 ± 5.5 vs. 16.64 ± 4.1, <i>p</i> < 0.001). Significant correlations were noted between KCCQ and BDI scores (<i>r</i> = −0.849, <i>p</i> < 0.001) and central apnea events (<i>r</i> = −0.485, <i>p</i> < 0.001). <b>Conclusions</b>: Sleep apnea is common in ADHF patients, with CSA being linked to poorer QoL and greater depression. Personalized medicine offers promising strategies to enhance care and outcomes.https://www.mdpi.com/2392-7674/12/1/18obstructive sleep apneacentral sleep apneasleep disorderssleep apnea phenotypspatient-reported outcomes
spellingShingle Petar Kalaydzhiev
Tsvetelina Velikova
Gergana Voynova
Desislava Somleva
Natalia Spasova
Radostina Ilieva
Elena Kinova
Assen Goudev
Quality of Life and Mental Health in Patients with Exacerbated Heart Failure: The Role of Obstructive and Central Sleep Apnea Phenotypes
Journal of Mind and Medical Sciences
obstructive sleep apnea
central sleep apnea
sleep disorders
sleep apnea phenotyps
patient-reported outcomes
title Quality of Life and Mental Health in Patients with Exacerbated Heart Failure: The Role of Obstructive and Central Sleep Apnea Phenotypes
title_full Quality of Life and Mental Health in Patients with Exacerbated Heart Failure: The Role of Obstructive and Central Sleep Apnea Phenotypes
title_fullStr Quality of Life and Mental Health in Patients with Exacerbated Heart Failure: The Role of Obstructive and Central Sleep Apnea Phenotypes
title_full_unstemmed Quality of Life and Mental Health in Patients with Exacerbated Heart Failure: The Role of Obstructive and Central Sleep Apnea Phenotypes
title_short Quality of Life and Mental Health in Patients with Exacerbated Heart Failure: The Role of Obstructive and Central Sleep Apnea Phenotypes
title_sort quality of life and mental health in patients with exacerbated heart failure the role of obstructive and central sleep apnea phenotypes
topic obstructive sleep apnea
central sleep apnea
sleep disorders
sleep apnea phenotyps
patient-reported outcomes
url https://www.mdpi.com/2392-7674/12/1/18
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