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Sleep apnea in congestive heart failure
1Sleep Research Laboratory, Rehabilitation Institute of Toronto, University of Toronto, Ontario, Canada.
Clinics in Chest Medicine
|April 29, 1998
Summary
Obstructive sleep apnea (OSA) and central sleep apnea (CSA) worsen heart failure. Continuous positive airway pressure (CPAP) can improve cardiac function for both conditions in heart failure patients.
Area of Science:
- Cardiology
- Pulmonology
- Sleep Medicine
Background:
- Sleep-related breathing disorders, including obstructive sleep apnea (OSA) and Cheyne-Stokes respiration with central sleep apnea (CSR-CSA), are prevalent in congestive heart failure (CHF) patients.
- These disorders can adversely affect cardiovascular function in patients with CHF.
Purpose of the Study:
- To review the pathophysiologic effects of OSA and CSR-CSA in CHF.
- To discuss the impact of treatments for these sleep disorders on cardiac function and mortality in CHF.
Main Methods:
- Literature review and synthesis of existing research on sleep-related breathing disorders in CHF.
- Analysis of the effects of various treatments, including CPAP, oxygen, and theophylline, on cardiac function and mortality.
Main Results:
- OSA can exacerbate left ventricular (LV) dysfunction in CHF by increasing afterload and sympathetic nervous system activation.
- CSR-CSA is likely a consequence of CHF and is associated with increased mortality, potentially due to hypoxia and sleep arousals.
- Continuous positive airway pressure (CPAP) can improve cardiac function in CHF patients with OSA and CSR-CSA.
Conclusions:
- Effective treatment of OSA and CSR-CSA may serve as valuable adjunctive therapies to standard pharmacologic treatment for CHF.
- CPAP demonstrates efficacy in improving cardiac function and symptoms in CHF patients with both OSA and CSR-CSA.