title: Heart failure and sleep disorders.
abstract: Awareness of the importance of sleep-related disorders in patients with cardiovascular diseases is growing. In particular, sleep-disordered breathing, short sleep time, and low sleep quality are frequently reported by patients with heart failure (HF). Sleep-disordered breathing, which includes obstructive sleep apnoea (OSA) and central sleep apnoea (CSA), is common in patients with HF and has been suggested to increase the morbidity and mortality in these patients. Both OSA and CSA are associated with increased sympathetic activation, vagal withdrawal, altered haemodynamic loading conditions, and hypoxaemia. Moreover, OSA is strongly associated with arterial hypertension, the most common risk factor for cardiac hypertrophy and failure. Intrathoracic pressure changes are also associated with OSA, contributing to haemodynamic alterations and potentially affecting overexpression of genes involved in ventricular remodelling. HF treatment can decrease the severity of both OSA and CSA. Indeed, furosemide and spironolactone administration, exercise training, cardiac resynchronization therapy, and eventually heart transplantation have shown a positive effect on OSA and CSA in patients with HF. At present, whether CSA should be treated and, if so, which is the optimal therapy is still debated. By contrast, more evidence is available on the beneficial effects of OSA treatment in patients with HF.
authors.affiliation: Department of Cardiovascular, Neural, and Metabolic Sciences, San Luca Hospital, Istituto Auxologico Italiano, Piazza Brescia 20, 20149 Milan, Italy.|Sleep Medicine Centre, San Luca Hospital, IRCCS, Istituto Auxologico Italiano, Piazzale Brescia 20, 20149 Milan, Italy.|Department of Medicine and Surgery, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126 Milan, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Parati
authors.affiliation: Department of Cardiovascular, Neural, and Metabolic Sciences, San Luca Hospital, Istituto Auxologico Italiano, Piazza Brescia 20, 20149 Milan, Italy.|Sleep Medicine Centre, San Luca Hospital, IRCCS, Istituto Auxologico Italiano, Piazzale Brescia 20, 20149 Milan, Italy.
authors.forename: Carolina
authors.initials: C
authors.lastname: Lombardi
authors.affiliation: Department of Cardiovascular, Neural, and Metabolic Sciences, San Luca Hospital, Istituto Auxologico Italiano, Piazza Brescia 20, 20149 Milan, Italy.|Sleep Medicine Centre, San Luca Hospital, IRCCS, Istituto Auxologico Italiano, Piazzale Brescia 20, 20149 Milan, Italy.|Department of Medicine, Columbia University, 622 West 168th Street, New York, New York 10032, USA.
authors.forename: Francesco
authors.initials: F
authors.lastname: Castagna
authors.affiliation: Department of Cardiovascular, Neural, and Metabolic Sciences, San Luca Hospital, Istituto Auxologico Italiano, Piazza Brescia 20, 20149 Milan, Italy.|Sleep Medicine Centre, San Luca Hospital, IRCCS, Istituto Auxologico Italiano, Piazzale Brescia 20, 20149 Milan, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Mattaliano
authors.affiliation: Department of Advanced Biomedical Sciences, Federico II University, Corso Umberto I 40, 80138 Naples, Italy.
authors.forename: Pasquale Perrone
authors.initials: PP
authors.lastname: Filardi
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via Carlo Parea 4, 20138 Milan, Italy.|Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy.
authors.forename: Piergiuseppe
authors.initials: P
authors.lastname: Agostoni
mesh_terms: D020920:Dyssomnias / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy