Sleep disorders in patients with acute and exacerbated chronic heart failure

Heart failure is often accompanied by sleep disorders. CPAP therapy has proven in the treatment of obstructive sleep apnea, but the benefits associated with comorbid patients and patients with heart failure is still under research. On the other hand, central sleep apnea is also with high frequency in these patients and more difficult to treat. The aim of the current publication is to make a brief review of acute and exacerbated chronic heart failure in patients with sleep disorders - frequency, severity, and types to treat.

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Sleep disorders in patients with overweight and acute and exacerbated chronic heart failure

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.029 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

PK Kalidjiev ◽

E Kinova ◽

D Somleva ◽

A Goudev

Keyword(s):

Heart Failure ◽

Sleep Apnea ◽

Chronic Heart Failure ◽

Ejection Fraction ◽

Sleep Disorders ◽

Central Sleep Apnea ◽

Left Ventricular ◽

Public Institution ◽

Left Ventricular Ejection ◽

Significant Difference

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Medical University - Sofia University Hospital "Tsaritsa Yoanna – ISUL” Background Often accompanying comorbidity in patients with heart failure and overweight is sleep disorders. Detection and treatment of sleep apnea will be helpful in these patients. Purpose To determine the phenotypic characteristics of sleep apnea in these patients. To determine whether there is a link between forms of sleep apnea and type of heart failure. Methods Hospitalized 46 patients with acute and exacerbate heart failure. Measuring of NT proBNP. Sleep apnea screening with ApneaLink™. Echocardiographic assessment of left ventricular ejection fraction (LVEF) and the E/e‘ ratio. Statistical methods to compare independent samples and correlation analysis for linear dependence. Results Of the 46 overweight patients with acute and exacerbated chronic heart failure, sleep apnea was diagnosed in 36 patients (78.2%). Of these, 83.3% (n = 30) have оbstructive sleep apnea (OSA) and 16.7% (n = 6) have central sleep apnea (CSA). There was a statistically significant difference in LVEF for the group with CSA (n = 6) vs group with OSA (n = 30) (41.67 ± 13.88 vs. 50.57 ± 8.16, p = 0.038). For diastolic function didn"t reach statistical significance for E/e" ratio (20,33 ± 5,00 vs. 17,06 ± 4,02, p = 0,089). Regarding NTproBNP, there is no significant difference between the groups with OSA and those with CSA (2978.5 ± 2664.1 vs. 2063.36 ± 1877.27 pg/ml, p = 0.316). There is a moderate negative correlation with LVEF and number of central sleep apnea events (r=-0,334, p = 0,047). Conclusions With greater frequency occurs obstructive sleep apnea. Left ventricular systolic function is lower in patients with central sleep apnea. There is a reverse correlation between ejection fraction and number of central apnea.

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Identifying Predictors of Central Sleep Apnea/Cheyne-Stokes Breathing in Chronic Heart Failure: a Pathophysiological Approach

Folia Medica ◽

10.1515/folmed-2016-0037 ◽

2016 ◽

Vol 58 (4) ◽

pp. 225-233 ◽

Cited By ~ 1

Author(s):

Aneliya I. Draganova ◽

Kiril V. Terziyski ◽

Stefan S. Kostianev

Keyword(s):

Heart Failure ◽

Sleep Apnea ◽

Chronic Heart Failure ◽

Treatment Options ◽

Central Sleep Apnea ◽

Feedback Gain ◽

Major Health Problem ◽

Obstructive Sleep ◽

Co Morbidity ◽

Cheyne Stokes Breathing

AbstractChronic heart failure (CHF) is a major health problem associated with increased mortality, despite modern treatment options. Central sleep apnea (CSA)/Cheyne-Stokes breathing (CSB) is a common and yet largely under-diagnosed co-morbidity, adding significantly to the poor prognosis in CHF because of a number of acute and chronic effects, including intermittent hypoxia, sympathetic overactivation, disturbed sleep architecture and impaired physical tolerance. It is characterized by repetitive periods of crescendo-decrescendo ventilatory pattern, alternating with central apneas and hypopneas. The pathogenesis of CSA/CSB is based on the concept of loop gain, comprising three major components: controller gain, plant gain and feedback gain. Laboratory polysomnography, being the golden standard for diagnosing sleep-disordered breathing (SDB) at present, is a costly and highly specialized procedure unable to meet the vast diagnostic demand. Unlike obstructive sleep apnea, CSA/CSB has a low clinical profile. Therefore, a reliable predictive system is needed for identifying CHF patients who are most likely to suffer from CSA/CSB, optimizing polysomnography use. The candidate predictors should be standardized, easily accessible and low-priced in order to be applied in daily medical routine.The present review focuses on a pathophysiological approach to the selection of some predictors based on parameters reflecting the etiology, the pathogenesis and the consequences of CSA/CSB in CHF.

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Prospects for the treatment of central sleep apnea and Cheyne-Stokes respiration in heart failure

South Russian Journal of Therapeutic Practice ◽

10.21886/2712-8156-2021-2-1-8-16 ◽

2021 ◽

Vol 2 (1) ◽

pp. 8-16

Author(s):

Y. V. Alyokhina ◽

E. M. Seredenina ◽

A. L. Kalinkin

Keyword(s):

Heart Failure ◽

Sleep Apnea ◽

Treatment Options ◽

Clinical Manifestations ◽

Central Sleep Apnea ◽

Cpap Therapy ◽

Therapeutic Approaches ◽

Adaptive Servo Ventilation ◽

Patients With Heart Failure ◽

Stimulation Of

The risk factors, clinical manifestations, pathophysiology, diagnosis and treatment options for central sleep apnea and Cheyne-Stokes respiration in patients with heart failure are highlighted in this review. The effectiveness and prospects of therapeutic approaches are discussed: CPAP therapy, adaptive servo ventilation, transvenous stimulation of the phrenic nerve.

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