{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T23:46:23Z","timestamp":1790034383461,"version":"4.0.1"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2016,3,1]],"date-time":"2016-03-01T00:00:00Z","timestamp":1456790400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U01 AG027810"],"award-info":[{"award-number":["U01 AG027810"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U01 AG042124"],"award-info":[{"award-number":["U01 AG042124"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U01 AG042139"],"award-info":[{"award-number":["U01 AG042139"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U01 AG042140"],"award-info":[{"award-number":["U01 AG042140"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U01 AG042143"],"award-info":[{"award-number":["U01 AG042143"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U01 AG042145"],"award-info":[{"award-number":["U01 AG042145"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U01 AG042168"],"award-info":[{"award-number":["U01 AG042168"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U01 AR066160"],"award-info":[{"award-number":["U01 AR066160"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UL1 TR000128"],"award-info":[{"award-number":["UL1 TR000128"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"NHLBI","doi-asserted-by":"publisher","award":["R01 HL071194"],"award-info":[{"award-number":["R01 HL071194"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"NHLBI","doi-asserted-by":"publisher","award":["R01 HL070848"],"award-info":[{"award-number":["R01 HL070848"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"NHLBI","doi-asserted-by":"publisher","award":["R01 HL070847"],"award-info":[{"award-number":["R01 HL070847"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"NHLBI","doi-asserted-by":"publisher","award":["R01 HL070842"],"award-info":[{"award-number":["R01 HL070842"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"NHLBI","doi-asserted-by":"publisher","award":["R01 HL070841"],"award-info":[{"award-number":["R01 HL070841"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"NHLBI","doi-asserted-by":"publisher","award":["R01 HL070837"],"award-info":[{"award-number":["R01 HL070837"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"NHLBI","doi-asserted-by":"publisher","award":["R01 HL070838"],"award-info":[{"award-number":["R01 HL070838"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"NHLBI","doi-asserted-by":"publisher","award":["R01 HL070839"],"award-info":[{"award-number":["R01 HL070839"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>The directionality of the relationship between sleep-disordered breathing and heart failure is controversial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We assessed whether elevations in the obstructive or central sleep apnea index or the presence of Cheyne-Stokes breathing are associated with decompensated and\/or incident heart failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective, longitudinal study of 2,865 participants derived from the Osteoporotic Fractures in Men Study, a prospective multicenter observational study of community-dwelling older men. Participants underwent baseline polysomnography and were followed for a mean 7.3 years for development of incident or decompensated heart failure. Our main exposures were the obstructive apnea\u2013hypopnea index (AHI), central apnea index (CAI \u22655), and Cheyne-Stokes breathing. Covariates included age, race, clinic site, comorbidities, physical activity, and alcohol and tobacco use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>CAI greater than or equal to five and presence of Cheyne-Stokes breathing but not obstructive AHI were significant predictors of incident heart failure (adjusted hazard ratio [HR], 1.79; 95% confidence interval [CI], 1.16\u20132.77 for CAI \u22655) (HR, 2.23; 95% CI, 1.45\u20133.43 for Cheyne-Stokes breathing). After excluding those with baseline heart failure, the incident risk of heart failure was attenuated for those with CAI greater than or equal to five (HR, 1.57; 95% CI, 0.92\u20132.66) but remained significantly elevated for those with Cheyne-Stokes breathing (HR, 1.90; 95% CI, 1.10\u20133.30).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>An elevated CAI\/Cheyne-Stokes breathing, but not an elevated obstructive AHI, is significantly associated with increased risk of decompensated heart failure and\/or development of clinical heart failure in a community-based cohort of older men.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.201503-0536oc","type":"journal-article","created":{"date-parts":[[2015,10,26]],"date-time":"2015-10-26T16:38:47Z","timestamp":1445877527000},"page":"561-568","source":"Crossref","is-referenced-by-count":82,"title":["Sleep-disordered Breathing and Incident Heart Failure in Older Men"],"prefix":"10.1093","volume":"193","author":[{"given":"Sogol","family":"Javaheri","sequence":"first","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terri","family":"Blackwell","sequence":"additional","affiliation":[{"name":"California Pacific Medical Center Research Institute and San Francisco Coordinating Center, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Ancoli-Israel","sequence":"additional","affiliation":[{"name":"University of California, San Diego, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine E.","family":"Ensrud","sequence":"additional","affiliation":[{"name":"University of Minnesota, Minneapolis, Minnesota; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie L.","family":"Stone","sequence":"additional","affiliation":[{"name":"California Pacific Medical Center Research Institute and San Francisco Coordinating Center, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Redline","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Boston, Massachusetts"},{"name":"Beth Israel Deaconess Medical Center, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2016,3,1]]},"reference":[{"key":"2026032100013161300_bib1","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1161\/CIR.0b013e31820a55f5","article-title":"Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association","volume":"123","author":"Heidenreich","year":"2011","journal-title":"Circulation"},{"key":"2026032100013161300_bib2","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1161\/01.cir.0000442015.53336.12","article-title":"Heart disease and stroke statistics--2014 update: a report from the American Heart Association","volume":"129","author":"Go","year":"2014","journal-title":"Circulation"},{"key":"2026032100013161300_bib3","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.ejheart.2006.08.003","article-title":"Sleep-disordered breathing in patients with symptomatic heart failure: a contemporary study of prevalence in and characteristics of 700 patients","volume":"9","author":"Oldenburg","year":"2007","journal-title":"Eur J Heart Fail"},{"key":"2026032100013161300_bib4","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1016\/j.cardfail.2011.01.013","article-title":"High prevalence of sleep apnea in heart failure outpatients: even in patients with preserved systolic function","volume":"17","author":"Herrscher","year":"2011","journal-title":"J Card Fail"},{"key":"2026032100013161300_bib5","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1093\/eurjhf\/hfp057","article-title":"Sleep-disordered breathing in heart failure with normal left ventricular ejection fraction","volume":"11","author":"Bitter","year":"2009","journal-title":"Eur J Heart Fail"},{"key":"2026032100013161300_bib6","doi-asserted-by":"crossref","first-page":"2028","DOI":"10.1016\/j.jacc.2007.01.084","article-title":"Central sleep apnea, right ventricular dysfunction, and low diastolic blood pressure are predictors of mortality in systolic heart failure","volume":"49","author":"Javaheri","year":"2007","journal-title":"J Am Coll Cardiol"},{"key":"2026032100013161300_bib7","doi-asserted-by":"crossref","first-page":"3173","DOI":"10.1161\/CIRCULATIONAHA.106.683482","article-title":"Suppression of central sleep apnea by continuous positive airway pressure and transplant-free survival in heart failure: a post hoc analysis of the Canadian Continuous Positive Airway Pressure for Patients with Central Sleep Apnea and Heart Failure Trial (CANPAP)","volume":"115","author":"Arzt","year":"2007","journal-title":"Circulation"},{"key":"2026032100013161300_bib8","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1378\/chest.07-1901","article-title":"Prognosis of patients with heart failure and obstructive sleep apnea treated with continuous positive airway pressure","volume":"133","author":"Kasai","year":"2008","journal-title":"Chest"},{"key":"2026032100013161300_bib9","doi-asserted-by":"crossref","first-page":"e76352","DOI":"10.1371\/journal.pone.0076352","article-title":"Impact of untreated obstructive sleep apnea on left and right ventricular myocardial function and effects of CPAP therapy","volume":"8","author":"Hammerstingl","year":"2013","journal-title":"PLoS One"},{"key":"2026032100013161300_bib10","doi-asserted-by":"crossref","first-page":"1827","DOI":"10.1378\/chest.119.6.1827","article-title":"Hemodynamic effects of simulated obstructive apneas in humans with and without heart failure","volume":"119","author":"Bradley","year":"2001","journal-title":"Chest"},{"key":"2026032100013161300_bib11","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1164\/ajrccm\/141.4_Pt_1.871","article-title":"Cheyne-Stokes respiration presenting as sleep apnea syndrome. Clinical and polysomnographic features","volume":"141","author":"Dowdell","year":"1990","journal-title":"Am Rev Respir Dis"},{"key":"2026032100013161300_bib12","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.jacc.2010.08.627","article-title":"Obstructive sleep apnea and heart failure: pathophysiologic and therapeutic implications","volume":"57","author":"Kasai","year":"2011","journal-title":"J Am Coll Cardiol"},{"key":"2026032100013161300_bib13","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1161\/CIRCULATIONAHA.109.901801","article-title":"Prospective study of obstructive sleep apnea and incident coronary heart disease and heart failure: the Sleep Heart Health Study","volume":"122","author":"Gottlieb","year":"2010","journal-title":"Circulation"},{"key":"2026032100013161300_bib14","author":"Javaheri"},{"key":"2026032100013161300_bib15","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/j.cct.2005.05.006","article-title":"Design and baseline characteristics of the Osteoporotic Fractures in Men (MrOS) Study: a large observational study of the determinants of fracture in older men","volume":"26","author":"Orwoll","year":"2005","journal-title":"Contemp Clin Trials"},{"key":"2026032100013161300_bib16","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1016\/j.cct.2005.05.005","article-title":"Overview of recruitment for the Osteoporotic Fractures in Men Study (MrOS)","volume":"26","author":"Blank","year":"2005","journal-title":"Contemp Clin Trials"},{"key":"2026032100013161300_bib17","volume-title":"The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications","author":"Iber","year":"2007"},{"key":"2026032100013161300_bib18","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1093\/sleep\/21.7.759","article-title":"Methods for obtaining and analyzing unattended polysomnography data for a multicenter study","volume":"21","author":"Redline","year":"1998","journal-title":"Sleep"},{"key":"2026032100013161300_bib19","doi-asserted-by":"crossref","first-page":"e1000132","DOI":"10.1371\/journal.pmed.1000132","article-title":"Sleep-disordered breathing and mortality: a prospective cohort study","volume":"6","author":"Punjabi","year":"2009","journal-title":"PLoS Med"},{"key":"2026032100013161300_bib20","first-page":"1071","article-title":"Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort","volume":"31","author":"Young","year":"2008","journal-title":"Sleep"},{"key":"2026032100013161300_bib21","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1080\/01621459.1999.10474144","article-title":"A proportional hazards model for the subdistribution of a competing risk","volume":"94","author":"Fine","year":"1999","journal-title":"J Am Stat Assoc"},{"key":"2026032100013161300_bib22","doi-asserted-by":"crossref","first-page":"2154","DOI":"10.1161\/01.CIR.97.21.2154","article-title":"Sleep apnea in 81 ambulatory male patients with stable heart failure. Types and their prevalences, consequences, and presentations","volume":"97","author":"Javaheri","year":"1998","journal-title":"Circulation"},{"key":"2026032100013161300_bib23","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1378\/chest.123.4.1119","article-title":"Impact of sleep apnea on sympathetic nervous system activity in heart failure","volume":"123","author":"Solin","year":"2003","journal-title":"Chest"},{"key":"2026032100013161300_bib24","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1016\/S0140-6736(05)71141-7","article-title":"Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study","volume":"365","author":"Marin","year":"2005","journal-title":"Lancet"},{"key":"2026032100013161300_bib25","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1183\/09059180.00010610","article-title":"Mortality in sleep apnoea syndrome: a review of the evidence","volume":"16","author":"Lavie","year":"2007","journal-title":"Eur Respir Rev"},{"key":"2026032100013161300_bib26","doi-asserted-by":"crossref","first-page":"702","DOI":"10.2337\/diacare.26.3.702","article-title":"Diabetes and sleep disturbances: findings from the Sleep Heart Health Study","volume":"26","author":"Resnick","year":"2003","journal-title":"Diabetes Care"}],"container-title":["American Journal of Respiratory and Critical Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/193\/5\/561\/67254797\/ajrccm_193_5_561.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/193\/5\/561\/67254797\/ajrccm_193_5_561.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T04:01:43Z","timestamp":1774065703000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajrccm\/article\/193\/5\/561\/8508776"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,3,1]]},"references-count":26,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2016,3,1]]},"published-print":{"date-parts":[[2016,3,1]]}},"URL":"https:\/\/doi.org\/10.1164\/rccm.201503-0536oc","relation":{},"ISSN":["1073-449X","1535-4970"],"issn-type":[{"value":"1073-449X","type":"print"},{"value":"1535-4970","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2016,3]]},"published":{"date-parts":[[2016,3,1]]}}}