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Sleep-disordered Breathing in Heart Failure.

Simon G Pearse1, Martin R Cowie1, Rakesh Sharma1

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Summary
This summary is machine-generated.

Sleep-disordered breathing is common in heart failure (HF) and linked to poor outcomes. Continuous positive airway pressure may benefit obstructive sleep apnea, but risks exist for other types in HF patients.

Keywords:
ASVCPAPSleep-disordered breathingheart failuresleep apnoea

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Area of Science:

  • Cardiology
  • Pulmonology
  • Sleep Medicine

Background:

  • Sleep-disordered breathing (SDB) affects over 50% of heart failure (HF) patients.
  • SDB is under-diagnosed and associated with poor HF prognosis.
  • SDB presents as obstructive sleep apnea (OSA) or central sleep apnea (CSA).

Purpose of the Study:

  • To review the pathophysiology and clinical implications of SDB in HF.
  • To discuss current and evolving management strategies for SDB in HF.
  • To highlight the diagnostic and therapeutic challenges in this patient population.

Main Methods:

  • Review of current literature on SDB in HF.
  • Analysis of the cardiovascular effects of OSA and CSA.
  • Evaluation of treatment outcomes for positive airway pressure therapies.

Main Results:

  • OSA in HF involves pharyngeal collapse, negative intrathoracic pressure, hypoxemia, and sympathetic activation.
  • Continuous positive airway pressure (CPAP) may improve symptoms and prognosis in HF-OSA.
  • Adaptive servoventilation in HF-CSA showed increased mortality in the SERVE-HF trial.

Conclusions:

  • SDB is a critical, often overlooked, comorbidity in heart failure.
  • CPAP is a potential therapeutic target for HF patients with OSA.
  • Management of SDB in HF requires careful consideration of specific sleep apnea types due to varying treatment outcomes.