Sleep-disordered Breathing in Heart Failure

Sleep-related breathing disorders are common in heart failure patients and can have significant adverse impact on clinical outcomes. If sleep-disordered breathing or considerable daytime sleepiness exists, assessment and treatment recommendations include the following: 1) carefully assess and correct hemodynamic status; heart failure exacerbations can induce central sleep apneas; 2) if overweight, encourage patient weight loss; 3) elevate head of bed; 4) discourage sleeping on back; 5) order polysomnography, to assess type and extent of sleep-related breathing disorder; and 6) treat sleep-disordered breathing with nasal continuous positive airway pressure or bilevel positive airway pressure.