Fluid Retention and Rostral Fluid Shift in Sleep-Disordered Breathing

Sleep-disordered breathing (SDB) is common and adversely affects cardiovascular morbidity and mortality. Despite multifactorial pathogenesis, SDB is prevalent in patients with fluid retention disorders, such as drug-resistant hypertension, end-stage renal disease, and heart failure, suggesting that fluid retention may play a role in the pathogenesis of SDB. During the day, fluid is likely to accumulate in the legs, and upon lying down at night is displaced from the legs. Many data suggest that some of this fluid displaced from the legs may redistribute to the upper body and predispose to SDB. This review article will highlight evidence for a relationship between SDB and fluid retention or rostral fluid shift, and discuss mechanisms that link them.