Management of Sleep Apnea Syndromes in Heart Failure.
Central sleep apnea (CSA) and obstructive sleep apnea (OSA) are prevalent in heart failure (HF) and associated with a worse prognosis. Nocturnal oxygen therapy may decrease CSA events, sympathetic tone, and improve left ventricular ejection fraction, although mortality benefit is unknown. Although treatment of OSA in patients with HF is recommended, therapy for CSA remains controversial. Continuous positive airway pressure use in HF-CSA may improve respiratory events, hemodynamics, and exercise capacity, but not mortality. Adaptive servo ventilation is contraindicated in patients with symptomatic HF with predominant central sleep-disordered events. The role of phrenic nerve stimulation in CSA therapy is promising.
Division of Pulmonary and Critical Care Medicine, Mayo Clinic Center for Sleep Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA. Electronic address: Selim.bernardo@mayo.edu.
Bernardo J
BJ
Selim
Division of Pulmonary and Critical Care Medicine, Mayo Clinic Center for Sleep Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
Kannan
K
Ramar
D006333:Heart Failure / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*
Central sleep apnea; Cheyne-Stokes breathing; Heart failure; Obstructive sleep apnea; Oxygen; Positional therapy; Positive airway pressure; Sleep-disordered breathing