Sleep-Disordered Breathing and Heart Failure: Focus on Obstructive Sleep Apnea and Treatment With Continuous Positive Airway Pressure
Received 8 October 2008; received in revised form 11 August 2009; accepted 17 August 2009. published online 29 October 2009.
Abstract
Background
Among patients with heart failure, sleep-disordered breathing is a common problem, with a prevalence ranging from 24% to 76%. Encompassed within the general category of sleep-disordered breathing are 2 types of sleep apnea: obstructive sleep apnea (OSA) occurs when the oropharyngeal musculature relaxes, causing a collapse of the upper airway, and central sleep apnea occurs when the brain stem fails to stimulate breathing.
Methods and Results
This article focuses on the relationship between heart failure and OSA, the treatment of OSA with continuous positive airway pressure (CPAP), and the role of CPAP in improving such effects of heart failure as ejection fraction, blood pressure, sympathetic activity, sleepiness, heart rate, and mortality.
Conclusions
It is important to distinguish the type of sleep-disordered breathing a patient may have. Further studies are needed to elucidate the effects of CPAP and other therapies.
1Department of Internal Medicine, Emory University, Atlanta, GA
2Thomas Jefferson University, Jefferson Medical College, Philadelphia, PA
Reprints to: David J. Whellan, MD, MHS, FACC, Jefferson Medical College, Division of Cardiology, Department of Medicine, 1015 Chestnut Street, Room 317, Philadelphia, PA 19107. Tel: (215) 955-2007; Fax: (215) 503-7420.
ABSTRACT