title: [Sleep apnea and heart failure: pathophysiology, diagnosis and therapy].
abstract: Sleep apnea, defined as a pathologic pause in breathing during sleep >10 s, promotes the progression of chronic heart failure and may be a predictor of poor prognosis. It causes, in fact, several mechanical, hemodynamic, chemical and inflammatory changes that negatively compromise cardiovascular homeostasis of heart failure patients. Sleep apnea is recognized as sleep apnea syndrome when specific symptoms, such as sleepiness and headache during the daytime and snoring, are present and is diagnosed with an overnight test called polysomnography. There are two different forms of sleep apnea, central and obstructive. Breathing is interrupted by the loss of respiratory drive and the lack of respiratory effort in the central form, which affects about 40-60% of heart failure patients. In obstructive sleep apnea, breathing stops when throat muscles relax, despite respiratory effort. This form affects about 3% of the general population, while it is present in at least 30% of heart failure patients. The diagnosis of sleep disorders in heart failure becomes very important to help patients adopting lifestyle changes and starting specific therapies to improve quality of life and retard the progression of chronic heart failure.
authors.affiliation: Dipartimento di Medicina Interna, Scienze Cardiovascolari ed Immunologiche, Università degli Studi Federico II, Napoli.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Monda
authors.forename: Oriana
authors.initials: O
authors.lastname: Scala
authors.forename: Stefania
authors.initials: S
authors.lastname: Paolillo
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Savarese
authors.forename: Milena
authors.initials: M
authors.lastname: Cecere
authors.forename: Carmen
authors.initials: C
authors.lastname: D'Amore
authors.forename: Antonio
authors.initials: A
authors.lastname: Parente
authors.forename: Francesca
authors.initials: F
authors.lastname: Musella
authors.forename: Susanna
authors.initials: S
authors.lastname: Mosca
authors.forename: Pasquale Perrone
authors.initials: PP
authors.lastname: Filardi
mesh_terms: D058406:Cardiac Resynchronization Therapy / Q000379:methods; D006333:Heart Failure / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D010102:Oxygen Inhalation Therapy; D017286:Polysomnography; D011175:Positive-Pressure Respiration / Q000379:methods; D012890:Sleep / Q000502:physiology; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy