Sleep-Disordered Breathing in Patients with Heart Failure

Abstract

Breathing disturbances during sleep play a significant role in patients with cardiac diseases due to their high prevalence and impact on outcome. Obstructive sleep apnea (OSA) is a major risk factor of arterial hypertension and is associated with atrial fibrillation. A majority of heart failure (HF) patients suffer from OSA or central sleep apnoea (CSA), both associated with impaired prognosis. The application of continuous positive airway pressure has proven to improve symptoms and outcome in severe OSA. However, optimal therapy of CSA in heart failure is under discussion. Adaptive servoventilation (ASV) allows for counterbalancing the shift between hyperventilation and hypoventilation in periodic breathing. It has been shown to be superior to oxygen, continuous positive airway pressure therapy (CPAP) or other therapeutical options in HF patients with CSA. However, due to recent data, its use should be adapted closely to current indications and contraindications.