title: Sleep disordered breathing in patients with heart failure.
abstract: Sleep disordered breathing (SDB) is a common co-morbidity in patients with heart failure (HF). Both its forms - central and obstructive sleep apnea - are highly prevalent in this population. SDB fragments sleep, impairs life quality, worsens exercise tolerance, worsens HF and is an independent predictor of poor prognosis. Still, SDB remains largely undiagnosed. Therefore, early detection of SDB seems to be of primary importance, especially in the presence of new diagnostic and therapeutic methods. Treatment with continuous positive airway pressure (CPAP) increases left ventricular ejection fraction and stroke volume in virtually all HF patients with obstructive and in 50% with central sleep apnea. For those in whom central sleep apnea is not suppressed by CPAP, a trial of adaptive servoventilation is recommended. Although no randomized, controlled trials have shown improvement in mortality, several observational studies have shown that effective treatment of both forms of sleep apnea with various positive airway pressure devices improves survival of HF patients. Currently, 2 large trials with newer masked based therapies with adaptive servoventilation are in progress. This article is a brief overview of present knowledge, the pathophysiology, diagnostic approach and therapy of SDB.
authors.affiliation: krawmag@gmail.com.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Krawczyk
authors.forename: Irena
authors.initials: I
authors.lastname: Flinta
authors.forename: Magdalena
authors.initials: M
authors.lastname: Garncarek
authors.forename: Ewa Anita
authors.initials: EA
authors.lastname: Jankowska
authors.forename: Waldemar
authors.initials: W
authors.lastname: Banasiak
authors.forename: Robin
authors.initials: R
authors.lastname: Germany
authors.forename: Shahrokh
authors.initials: S
authors.lastname: Javaheri
authors.forename: Piotr
authors.initials: P
authors.lastname: Ponikowski
mesh_terms: D015897:Comorbidity; D045422:Continuous Positive Airway Pressure; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D015995:Prevalence; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D016896:Treatment Outcome