Sleep-disordered breathing, cognitive functioning, and adherence in heart failure: linked through pathology?
Heart failure (HF) is well recognized as a condition resulting from chronic neurohormonal activation. Sleep-disordered breathing (SDB) as a neurohormonal disorder is less recognized. In SDB, whether obstructive or central in nature, nightly repetitive cycles of hypoxia-reoxygenation produce intense sympathetic activation and deprive the body of much needed sleep. Both HF and SDB are associated with fatigue, cognitive impairment, and challenges for adherence to prescribed therapies. Together, the combination of HF and SDB can have particularly ominous consequences for cognitive functioning, decision making, adherence and, ultimately, outcomes. The suboptimal adherence seen in patients with both HF and SDB may result from a neurohormonal synergism that exists between the 2 conditions.
Trupp
Robin J
RJ
Ohio State University, College of Nursing, Columbus, OH, USA. trupp3@osu.edu
Corwin
Elizabeth J
EJ
D003072:Cognition Disorders / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008954:Models, Biological; D008960:Models, Psychological; D015213:Neuroimmunomodulation / Q000502:physiology*; D018377:Neurotransmitter Agents / Q000502:physiology*; D010349:Patient Compliance / Q000523:psychology*; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000209:etiology / Q000503:physiopathology / Q000523:psychology
D018377:Neurotransmitter Agents