Impact of Hypopnoea Classifications on the Assessment of Sleep Disordered Breathing in Heart Failure

Sleep-related breathing disorders (SRBD), particularly central sleep apnoea and obstructive sleep apnoea, are highly prevalent among individuals with heart failure (HF). Accurate classification of SRBD is critical for accurate diagnosis and to improve management by limiting treatment failures. Hypopnoeas, defined as partial reductions in airflow, represent a significant proportion of respiratory events; however, inconsistencies in their scoring across various guidelines have affected disease classification and may lead to inappropriate treatment indications. This review examines the substantial impact that variations in hypopnoea definitions and the differentiation between central and obstructive hypopnoeas have on SRBD diagnosis in HF patients. The authors underscore the clinical and epidemiological importance of standardising hypopnoea scoring and advocate for the development of refined, HF-specific methodologies in SRBD assessment.