scholarly journals Differential impact of body position on the severity of disordered breathing in heart failure patients with obstructive vs. central sleep apnoea

2015 ◽  
Vol 17 (12) ◽  
pp. 1302-1309 ◽  
Author(s):  
Gian Domenico Pinna ◽  
Elena Robbi ◽  
Maria Teresa La Rovere ◽  
Anna Eugenia Taurino ◽  
Claudio Bruschi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Body Position ◽  
Sleep Apnoea ◽  
Differential Impact ◽  
Heart Failure Patients ◽  
Central Sleep Apnoea ◽  
Disordered Breathing

scholarly journals Daytime periodic breathing during short-term laboratory recordings in heart failure patients: the iceberg tip of central sleep apnoea?

2017 ◽  
Vol 20 (5) ◽  
pp. 934-936 ◽  
Author(s):  
Maria Teresa La Rovere ◽  
Roberto Maestri ◽  
Elena Robbi ◽  
Angelo Caporotondi ◽  
Giampaolo Guazzotti ◽  
...  
Keyword(s):  
Heart Failure ◽  
Periodic Breathing ◽  
Sleep Apnoea ◽  
Short Term ◽  
Heart Failure Patients ◽  
Central Sleep Apnoea

Co-morbidity (HFrEF and HFpEF): sleep-disordered breathing

ESC CardioMed ◽  
2018 ◽  
pp. 1829-1832
Author(s):  
Martin R Cowie
Keyword(s):  
Heart Failure ◽  
Sleep Disordered Breathing ◽  
Systolic Heart Failure ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Respiratory Physiology ◽  
Sympathetic Activation ◽  
Central Sleep Apnoea ◽  
Haemodynamic Changes ◽  
Disordered Breathing

The majority of patients with heart failure have sleep-disordered breathing. There are two major types—obstructive (where the upper airway collapses, but respiratory effort continues) and central (with loss of central respiratory drive). The cyclical apnoea and hypopneas are associated with sleep disturbance, hypoxaemia, haemodynamic changes, and sympathetic activation. Heart failure patients appear to be partially protected from the daytime somnolence that usually accompanies sleep-disordered breathing, perhaps by a high level of background sympathetic activation. Patients with sleep-disordered breathing have a worse prognosis than those without. Improving the control of the heart failure syndrome can improve sleep-disordered breathing. Mask-based therapies of positive airway pressure targeted at sleep-disordered breathing can improve measures of sleep quality and partially normalize the sleep and respiratory physiology, but recent randomized trials of cardiovascular outcomes in central sleep apnoea have been neutral or have even suggested the possibility of harm, likely from increased sudden death. Further randomized outcome studies are required to determine whether mask-based treatment is appropriate for patients with chronic systolic heart failure and obstructive sleep apnoea, for those with heart failure with preserved ejection fraction, and for those with decompensated heart failure. New therapies for central sleep apnoea—such as implantable phrenic nerve stimulators—also require robust assessment.

Short-term use of adaptive servo ventilation improves renal function in heart failure patients with sleep-disordered breathing

2012 ◽  
Vol 28 (6) ◽  
pp. 728-734 ◽  
Author(s):  
Akiomi Yoshihisa ◽  
Satoshi Suzuki ◽  
Takashi Owada ◽  
Shoji Iwaya ◽  
Hiroyuki Yamauchi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Sleep Disordered Breathing ◽  
Short Term ◽  
Adaptive Servo Ventilation ◽  
Heart Failure Patients ◽  
Disordered Breathing

scholarly journals Adaptive servo ventilation for central sleep apnoea in heart failure: SERVE-HF on-treatment analysis

2017 ◽  
Vol 50 (2) ◽  
pp. 1601692 ◽  
Author(s):  
Holger Woehrle ◽  
Martin R. Cowie ◽  
Christine Eulenburg ◽  
Anna Suling ◽  
Christiane Angermann ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sleep Apnoea ◽  
Adaptive Servo Ventilation ◽  
Central Sleep Apnoea ◽  
Treatment Analysis

Sleep apnoea: treatment options and sleep/cardiovascular outcome

ESC CardioMed ◽  
2018 ◽  
pp. 1065-1069
Author(s):  
Holger Woehrle ◽  
Michael Arzt
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Invasive Ventilation ◽  
Adaptive Servo Ventilation ◽  
Central Sleep Apnoea ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
New Treatment

In addition to lifestyle interventions, treatments for obstructive sleep apnoea focus on maintaining upper airway patency. Continuous positive airway pressure (CPAP) is recommended as first-line therapy. Beneficial cardiovascular effects of CPAP include increased intrathoracic pressure, reduced left ventricular preload and afterload, and reduced transmural cardiac pressure gradients. CPAP also reduces nocturnal ischaemia and blood pressure, and decreases the risk of post-treatment atrial fibrillation recurrence. However, secondary prevention with CPAP did not significantly reduce the rate of major cardio- and cerebrovascular events in the SAVE study. Mandibular advancement devices, surgery, and upper airway stimulation are options for patients unwilling to use or tolerate CPAP. Central sleep apnoea and Cheyne–Stokes respiration are common in patients with heart disease, especially heart failure. Adaptive servo-ventilation is the most effective therapy for alleviating central sleep apnoea with Cheyne–Stokes respiration. However, it is now contraindicated in heart failure patients with an ejection fraction of 45% or lower and predominant central sleep apnoea because of an increased risk of cardiovascular death, based on SERVE-HF study results. However, adaptive servo-ventilation may still have a role in other settings, including heart failure with preserved ejection fraction. Phrenic nerve stimulation is a new treatment modality that has shown promising results in a feasibility study. Hypoventilation is another breathing disorder that needs effective management. Data in cardiovascular disease are lacking, but CPAP and non-invasive ventilation have been shown to be effective in patients with obesity hypoventilation syndrome. Furthermore, effective reduction of chronic hypercapnia during home non-invasive ventilation treatment in patients with chronic obstructive pulmonary disease has been shown to significantly improve survival.

scholarly journals Biomarkers in patients with heart failure and central sleep apnoea: findings from the SERVE‐HF trial

2020 ◽  
Vol 7 (2) ◽  
pp. 503-511 ◽  
Author(s):  
João Pedro Ferreira ◽  
Kévin Duarte ◽  
Holger Woehrle ◽  
Martin R. Cowie ◽  
Karl Wegscheider ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sleep Apnoea ◽  
Central Sleep Apnoea ◽  
Patients With Heart Failure
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