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Sleep Disorder and Heart Failure with Preserved Ejection Fraction
Masahiko Kato1, Kazuhiro Yamamoto2
1Division of School of Health Science, Department of Pathobiological Science and Technology, Faculty of Medicine, Tottori University, 86 Nishicho, Yonago, Japan.
Heart Failure Clinics
|May 30, 2021
Summary
The relationship between sleep disorders and heart failure (HF) is bidirectional. Sleep disturbances can cause HF with preserved ejection fraction, while HF can also lead to sleep issues like insomnia and central sleep apnea.
Area of Science:
- Cardiology
- Sleep Medicine
- Pulmonology
Background:
- Obstructive sleep apnea (OSA) is often linked to heart failure (HF).
- HF can also cause sleep disorders such as insomnia and central sleep apnea (CSA).
- Emerging evidence highlights a complex, bidirectional relationship between sleep disorders and HF.
Purpose of the Study:
- To explore the bidirectional relationship between sleep disorders and heart failure.
- To elucidate the mechanisms by which sleep disorders contribute to heart failure with preserved left ventricular ejection fraction (HFpEF).
- To understand how heart failure may precipitate sleep disturbances.
Main Methods:
- Review of existing literature on sleep disorders and heart failure.
- Analysis of proposed pathophysiological pathways linking sleep disorders to HFpEF.
- Examination of mechanisms by which HF may induce sleep disorders.
Main Results:
- Sleep disorders can contribute to HFpEF through left atrial overload, left ventricular remodeling, pulmonary hypertension, and atrial fibrillation.
- Overnight rostral fluid shift and lung congestion in HF patients can cause upper airway obstruction and stimulate pulmonary receptors, leading to hyperventilation and sleep disorders.
- The relationship is complex, involving shared risk factors and feedback loops.
Conclusions:
- Sleep disorders and heart failure share a significant bidirectional relationship.
- Sleep disturbances are implicated in the development of HFpEF.
- Heart failure itself can precipitate or exacerbate sleep disorders, creating a detrimental cycle.
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