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Sleep disordered breathing in chronic heart failure

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Abstract

Heart failure is a growing problem, placing an increasing burden on public health resources and continuing to exert a high toll in mortality and morbidity. Sleep disordered breathing (SDB) is also a major public health problem and is associated with an increased risk of fatal and non-fatal cardiovascular events. Current evidence suggests SDB, particularly central SDB, is more prevalent in patients with chronic heart failure (CHF) than in the general population, but is under-diagnosed as SDB symptoms are less prevalent in CHF. This is further hampered by the absence of a simple and accurate screening tool and limited access to sleep facilities to diagnose SDB in the large numbers of patients with CHF. The presence of SDB in patients with CHF imposes increased haemodynamic burdens and results in autonomic abnormalities. Central SDB is an independent marker of worse prognosis, and evidence is increasing that obstructive SDB is also associated with higher mortality in patients with CHF. Optimal treatment of central SDB in these patients remains uncertain. While evidence of efficacy of positive pressure ventilation is stronger in obstructive SDB, improvement in survival for patients with both CHF and SDB awaits definitive trials. This paper summarizes our current understanding of the pathophysiology of SDB in CHF, and the cardiovascular consequences, and reviews the evidence for the beneficial effects of treatment of SDB in patients with CHF.

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References

  1. American Heart Association. Heart disease and stroke statistics—2005 update. Dallas, Texas: American Heart Association 2005

  2. Hobbs RE (2004) Guidelines for the diagnosis and management of heart failure. Am J Ther 11:467–472. doi:10.1097/01.mjt.0000127150.21184.01

    PubMed  Google Scholar 

  3. American Academy of Sleep Medicine task force (1999) Sleep-related breathing disorders in adults. Recommendations for syndrome definition and measurement techniques in clinical research. Sleep 22:667–689

    Google Scholar 

  4. Javaheri S, Parker TJ, Liming JD et al (1998) Sleep apnea in 81 ambulatory male patients with stable heart failure. Types and their prevalences, consequences, and presentations. Circulation 97:2154–2159

    PubMed  CAS  Google Scholar 

  5. Sin DD, Fitzgerald F, Parker JD, Newton G, Floras JS, Bradley TD (1999) Risk factors for central and obstructive sleep apnea in 450 men and women with congestive heart failure. Am J Respir Crit Care Med 160:1101–1106

    PubMed  CAS  Google Scholar 

  6. Tkacova R, Niroumand M, Lorenzi-Filho G, Bradley TD (2001) Overnight shift from obstructive to central apneas in patients with heart failure: role of PCO2 and circulatory delay. Circulation 103:238–243

    PubMed  CAS  Google Scholar 

  7. Bixler EO, Vgontzas AN, Ten Have T, Tyson K, Kales A (1998) Effects of age on sleep apnea in men: I. Prevalence and severity. Am J Respir Crit Care Med 157:144–148

    PubMed  CAS  Google Scholar 

  8. Shahar E, Whitney CW, Redline S et al (2001) Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study. Am J Respir Crit Care Med 163:19–25

    PubMed  CAS  Google Scholar 

  9. Yaggi HK, Concato J, Kernan WN, Lichtman JH, Brass LM, Mohsenin V (2005) Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med 353:2034–2041. doi:10.1056/NEJMoa043104

    PubMed  CAS  Google Scholar 

  10. Mansfield D, Kaye DM, Brunner La Rocca H, Solin P, Esler MD, Naughton MT (2003) Raised sympathetic nerve activity in heart failure and central sleep apnea is due to heart failure severity. Circulation 107:1396–1400. doi:10.1161/01.CIR.0000056520.17353.4F

    PubMed  Google Scholar 

  11. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S (1993) The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 328:1230–1235. doi:10.1056/NEJM199304293281704

    PubMed  CAS  Google Scholar 

  12. Lanfranchi PA, Braghiroli A, Bosimini E et al (1999) Prognostic value of nocturnal Cheyne-Stokes respiration in chronic heart failure. Circulation 99:1435–1440

    PubMed  CAS  Google Scholar 

  13. Leung RS, Bradley TD (2001) Sleep apnea and cardiovascular disease. Am J Respir Crit Care Med 164:2147–2165

    PubMed  CAS  Google Scholar 

  14. Bradley TD, Logan AG, Kimoff RJ et al (2005) Continuous positive airway pressure for central sleep apnea and heart failure. N Engl J Med 353:2025–2033. doi:10.1056/NEJMoa051001

    PubMed  CAS  Google Scholar 

  15. Staats BA, Bonekat HW, Harris CD, Offord KP (1984) Chest wall motion in sleep apnea. Am Rev Respir Dis 130:59–63

    PubMed  CAS  Google Scholar 

  16. Littner MR, Kushida C, Wise M et al (2005) Practice parameters for clinical use of the multiple sleep latency test and the maintenance of wakefulness test. Sleep 28:113–121

    PubMed  Google Scholar 

  17. Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep 14:540–545

    PubMed  CAS  Google Scholar 

  18. Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP (1999) Using the Berlin questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med 131:485–491

    PubMed  CAS  Google Scholar 

  19. Maislin G, Pack AI, Kribbs NB et al (1995) A survey screen for prediction of apnea. Sleep 18:158–166

    PubMed  CAS  Google Scholar 

  20. Brostrom A, Stromberg A, Dahlstrom U, Fridlund B (2004) Sleep difficulties, daytime sleepiness, and health-related quality of life in patients with chronic heart failure. J Cardiovasc Nurs 19:234–242

    PubMed  Google Scholar 

  21. Arzt M, Floras JS, Logan AG et al (2007) Suppression of central sleep apnea by continuous positive airway pressure and transplant-free survival in heart failure: a post hoc analysis of the Canadian continuous positive airway pressure for patients with central sleep apnea and heart failure trial (CANPAP). Circulation 115:3173–3180. doi:10.1161/CIRCULATIONAHA.106.683482

    PubMed  Google Scholar 

  22. Chesson AL Jr, Berry RB, Pack A (2003) Practice parameters for the use of portable monitoring devices in the investigation of suspected obstructive sleep apnea in adults. Sleep 26:907–913

    PubMed  Google Scholar 

  23. American Thoracic Society/American College of Chest Physicians/American Academy of Sleep Medicine Taskforce Steering Committee (2004) Executive summary on the systematic review and practice parameters for portable monitoring in the investigation of suspected sleep apnea in adults. Am J Respir Crit Care Med 169:1160–1163. doi:10.1164/rccm.169.1160

    Google Scholar 

  24. Guilleminault C, Connolly S, Winkle R, Melvin K, Tilkian A (1984) Cyclical variation of the heart rate in sleep apnoea syndrome. Mechanisms, and usefulness of 24 h electrocardiography as a screening technique. Lancet 1:126–131. doi:10.1016/S0140-6736(84)90062-X

    PubMed  CAS  Google Scholar 

  25. Roche F, Pichot V, Sforza E et al (2003) Predicting sleep apnoea syndrome from heart period: a time-frequency wavelet analysis. Eur Respir J 22:937–942

    PubMed  CAS  Google Scholar 

  26. Tateishi O, Shouda T, Sakai T, Honda Y, Mochizuki S, Machida K (2003) Apnea-related heart rate variability in congestive heart failure patients. Clin Exp Hypertens 25:183–189. doi:10.1081/CEH-120019150

    PubMed  Google Scholar 

  27. Leung RS, Floras JS, Lorenzi-Filho G, Rankin F, Picton P, Bradley TD (2003) Influence of Cheyne-Stokes respiration on cardiovascular oscillations in heart failure. Am J Respir Crit Care Med 167:1534–1539. doi:10.1164/rccm.200208-793OC

    PubMed  Google Scholar 

  28. Leung RS, Bowman ME, Diep TM, Lorenzi-Filho G, Floras JS, Bradley TD (2005) Influence of Cheyne-Stokes respiration on ventricular response to atrial fibrillation in heart failure. J Appl Physiol 99:1689–1696. doi:10.1152/japplphysiol.00027.2005

    PubMed  Google Scholar 

  29. Penzel T (2003) Is heart rate variability the simple solution to diagnose sleep apnoea? Eur Respir J 22:870–871

    PubMed  CAS  Google Scholar 

  30. Rosenberg P, Yancy CW (2000) Noninvasive assessment of hemodynamics: an emphasis on bioimpedance cardiography. Curr Opin Cardiol 15:151–155. doi:10.1097/00001573-200005000-00005

    PubMed  CAS  Google Scholar 

  31. Yasuda Y, Umezu A, Horihata S, Yamamoto K, Miki R, Koike S (2005) Modified thoracic impedance plethysmography to monitor sleep apnea syndromes. Sleep Med 6:215–224. doi:10.1016/j.sleep.2004.09.002

    PubMed  Google Scholar 

  32. Scharf C, Cho YK, Bloch KE et al (2004) Diagnosis of sleep-related breathing disorders by visual analysis of transthoracic impedance signals in pacemakers. Circulation 110:2562–2567. doi:10.1161/01.CIR.0000145540.36097.EB

    PubMed  Google Scholar 

  33. Bixler EO, Vgontzas AN, Lin HM et al (2001) Prevalence of sleep-disordered breathing in women: effects of gender. Am J Respir Crit Care Med 163:608–613

    PubMed  CAS  Google Scholar 

  34. Young T, Shahar E, Nieto FJ et al (2002) Predictors of sleep-disordered breathing in community-dwelling adults: the Sleep Heart Health Study. Arch Intern Med 162:893–900. doi:10.1001/archinte.162.8.893

    PubMed  Google Scholar 

  35. Lofaso F, Verschueren P, Rande JL, Harf A, Goldenberg F (1994) Prevalence of sleep-disordered breathing in patients on a heart transplant waiting list. Chest 106:1689–1694. doi:10.1378/chest.106.6.1689

    PubMed  CAS  Google Scholar 

  36. Chan J, Sanderson J, Chan W et al (1997) Prevalence of sleep-disordered breathing in diastolic heart failure. Chest 111:1488–1493. doi:10.1378/chest.111.6.1488

    PubMed  CAS  Google Scholar 

  37. Tremel F, Pepin JL, Veale D et al (1999) High prevalence and persistence of sleep apnoea in patients referred for acute left ventricular failure and medically treated over 2 months. Eur Heart J 20:1201–1209. doi:10.1053/euhj.1999.1546

    PubMed  CAS  Google Scholar 

  38. Solin P, Bergin P, Richardson M, Kaye DM, Walters EH, Naughton MT (1999) Influence of pulmonary capillary wedge pressure on central apnea in heart failure. Circulation 99:1574–1579

    PubMed  CAS  Google Scholar 

  39. CIBIS-II Investigators and Committe (1999) The cardiac insufficiency bisoprolol study II (CIBIS II): a randomised trial. Lancet 353:9–13. doi: 10.1016/S0140-6736(98)11181-9

    Google Scholar 

  40. MERIT-HF Study Group (1999) Effect of metoprolol CR/XL in chronic heart failure. Metoprolol CR/XL randomised intervention trial in congestive heart failure (MERIT-HF). Lancet 353:2001–2007. doi:10.1016/S0140-6736(99)04440-2

    Google Scholar 

  41. Packer M, Coats AJ, Fowler MB et al (2001) Effect of carvedilol on survival in severe chronic heart failure. N Engl J Med 344:1651–1658. doi:10.1056/NEJM200105313442201

    PubMed  CAS  Google Scholar 

  42. Lanfranchi PA, Somers VK, Braghiroli A, Corra U, Eleuteri E, Giannuzzi P (2003) Central sleep apnea in left ventricular dysfunction: prevalence and implications for arrhythmic risk. Circulation 107:727–732. doi:10.1161/01.CIR.0000049641.11675.EE

    PubMed  Google Scholar 

  43. Oldenburg O, Lamp B, Faber L, Teschler H, Horstkotte D, Topfer V (2007) Sleep-disordered breathing in patients with symptomatic heart failure a contemporary study of prevalence in and characteristics of 700 patients. Eur J Heart Fail 9:251–257. doi:10.1016/j.ejheart.2006.08.003

    PubMed  Google Scholar 

  44. Wang H, Parker JD, Newton GE et al (2007) Influence of obstructive sleep apnea on mortality in patients with heart failure. J Am Coll Cardiol 49:1625–1631. doi:10.1016/j.jacc.2006.12.046

    PubMed  Google Scholar 

  45. Marin JM, Carrizo SJ, Vicente E, Agusti AG (2005) Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 365:1046–1053

    PubMed  Google Scholar 

  46. Hung J, Whitford EG, Parsons RW, Hillman DR (1990) Association of sleep apnoea with myocardial infarction in men. Lancet 336:261–264. doi:10.1016/0140-6736(90)91799-G

    PubMed  CAS  Google Scholar 

  47. Schafer H, Koehler U, Ewig S, Hasper E, Tasci S, Luderitz B (1999) Obstructive sleep apnea as a risk marker in coronary artery disease. Cardiology 92:79–84. doi:10.1159/000006952

    PubMed  CAS  Google Scholar 

  48. Peppard PE, Young T, Palta M, Skatrud J (2000) Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 342:1378–1384. doi:10.1056/NEJM200005113421901

    PubMed  CAS  Google Scholar 

  49. Alonso-Fernandez A, Garcia-Rio F, Racionero MA et al (2005) Cardiac rhythm disturbances and ST-segment depression episodes in patients with obstructive sleep apnea-hypopnea syndrome and its mechanisms. Chest 127:15–22. doi:10.1378/chest.127.1.15

    PubMed  Google Scholar 

  50. Gami AS, Pressman G, Caples SM et al (2004) Association of atrial fibrillation and obstructive sleep apnea. Circulation 110:364–367. doi:10.1161/01.CIR.0000136587.68725.8E

    PubMed  Google Scholar 

  51. Mehra R, Benjamin EJ, Shahar E et al (2006) Association of nocturnal arrhythmias with sleep-disordered breathing: the Sleep Heart Health Study. Am J Respir Crit Care Med 173:910–916. doi:10.1164/rccm.200509-1442OC

    PubMed  Google Scholar 

  52. Javaheri S, Shukla R, Zeigler H, Wexler L (2007) Central sleep apnea, right ventricular dysfunction, and low diastolic blood pressure are predictors of mortality in systolic heart failure. J Am Coll Cardiol 49:2028–2034. doi:10.1016/j.jacc.2007.01.084

    PubMed  Google Scholar 

  53. Dempsey JA (2005) Crossing the apnoeic threshold: causes and consequences. Exp Physiol 90:13–24. doi:10.1113/expphysiol.2004.028985

    PubMed  Google Scholar 

  54. Javaheri S (1999) A mechanism of central sleep apnea in patients with heart failure. N Engl J Med 341:949–954. doi:10.1056/NEJM199909233411304

    PubMed  CAS  Google Scholar 

  55. Javaheri S (2005) Central sleep apnea in congestive heart failure: prevalence, mechanisms, impact, and therapeutic options. Semin Respir Crit Care Med 26:44–55. doi:10.1055/s-2005-864206

    PubMed  Google Scholar 

  56. White DP (2005) Pathogenesis of obstructive, central sleep apnea. Am J Respir Crit Care Med 172(11):1363–1370

    PubMed  Google Scholar 

  57. Krimsky WR, Leiter JC (2005) Physiology of breathing and respiratory control during sleep. Semin Respir Crit Care Med 26:5–12. doi:10.1055/s-2005-864197

    PubMed  Google Scholar 

  58. Fogel RB, Malhotra A, White DP (2004) Sleep. 2: pathophysiology of obstructive sleep apnoea/hypopnoea syndrome. Thorax 59:159–163. doi:10.1136/thorax.2003.015859

    PubMed  CAS  Google Scholar 

  59. Gibson GJ (2004) Obstructive sleep apnoea syndrome: underestimated and undertreated. Br Med Bull 72:49–65. doi:10.1093/bmb/ldh044

    PubMed  CAS  Google Scholar 

  60. Oksenberg A, Khamaysi I, Silverberg DS, Tarasiuk A (2000) Association of body position with severity of apneic events in patients with severe nonpositional obstructive sleep apnea. Chest 118:1018–1024. doi:10.1378/chest.118.4.1018

    PubMed  CAS  Google Scholar 

  61. De Backer WA (1995) Central sleep apnoea, pathogenesis and treatment: an overview and perspective. Eur Respir J 8:1372–1383. doi:10.1183/09031936.95.08081372

    PubMed  Google Scholar 

  62. Hall MJ, Xie A, Rutherford R, Ando S, Floras JS, Bradley TD (1996) Cycle length of periodic breathing in patients with and without heart failure. Am J Respir Crit Care Med 154:376–381

    PubMed  CAS  Google Scholar 

  63. Ryan CM, Bradley TD (2005) Periodicity of obstructive sleep apnea in patients with and without heart failure. Chest 127:536–542. doi:10.1378/chest.127.2.536

    PubMed  Google Scholar 

  64. Bradley TD, Floras JS (2003) Sleep apnea and heart failure: part I: obstructive sleep apnea. Circulation 107:1671–1678. doi:10.1161/01.CIR.0000061757.12581.15

    PubMed  Google Scholar 

  65. Bucca CB, Brussino L, Battisti A et al (2007) Diuretics in obstructive sleep apnea with diastolic heart failure. Chest 132:440–446. doi:10.1378/chest.07-0311

    PubMed  Google Scholar 

  66. Lavie L (2003) Obstructive sleep apnoea syndrome—an oxidative stress disorder. Sleep Med Rev 7:35–51. doi:10.1053/smrv.2002.0261

    PubMed  Google Scholar 

  67. Schulz R, Mahmoudi S, Hattar K et al (2000) Enhanced release of superoxide from polymorphonuclear neutrophils in obstructive sleep apnea. Impact of continuous positive airway pressure therapy. Am J Respir Crit Care Med 162:566–570

    PubMed  CAS  Google Scholar 

  68. Morrell MJ, Finn L, Kim H, Peppard PE, Badr MS, Young T (2000) Sleep fragmentation, awake blood pressure, and sleep-disordered breathing in a population-based study. Am J Respir Crit Care Med 162:2091–2096

    PubMed  CAS  Google Scholar 

  69. Kato M, Roberts-Thomson P, Phillips BG et al (2000) Impairment of endothelium-dependent vasodilation of resistance vessels in patients with obstructive sleep apnea. Circulation 102:2607–2610

    PubMed  CAS  Google Scholar 

  70. Schulz R, Hummel C, Heinemann S, Seeger W, Grimminger F (2002) Serum levels of vascular endothelial growth factor are elevated in patients with obstructive sleep apnea and severe nighttime hypoxia. Am J Respir Crit Care Med 165:67–70

    PubMed  Google Scholar 

  71. Shamsuzzaman AS, Winnicki M, Lanfranchi P et al (2002) Elevated C-reactive protein in patients with obstructive sleep apnea. Circulation 105:2462–2464. doi:10.1161/01.CIR.0000018948.95175.03

    PubMed  CAS  Google Scholar 

  72. Sanner BM, Konermann M, Tepel M, Groetz J, Mummenhoff C, Zidek W (2000) Platelet function in patients with obstructive sleep apnoea syndrome. Eur Respir J 16:648–652. doi:10.1034/j.1399-3003.2000.16d14.x

    PubMed  CAS  Google Scholar 

  73. Arnulf I, Merino-Andreu M, Perrier A, Birolleau S, Similowski T, Derenne JP (2002) Obstructive sleep apnea and venous thromboembolism. J Am Med Assoc 287:2655–2656. doi:10.1001/jama.287.20.2655

    Google Scholar 

  74. Coughlin SR, Mawdsley L, Mugarza JA, Calverley PM, Wilding JP (2004) Obstructive sleep apnoea is independently associated with an increased prevalence of metabolic syndrome. Eur Heart J 25:735–741. doi:10.1016/j.ehj.2004.02.021

    PubMed  Google Scholar 

  75. Phillips BG, Kato M, Narkiewicz K, Choe I, Somers VK (2000) Increases in leptin levels, sympathetic drive, and weight gain in obstructive sleep apnea. Am J Physiol Heart Circ Physiol 279:H234–H237

    PubMed  CAS  Google Scholar 

  76. Somers VK, Dyken ME, Clary MP, Abboud FM (1995) Sympathetic neural mechanisms in obstructive sleep apnea. J Clin Invest 96:1897–1904. doi:10.1172/JCI118235

    PubMed  CAS  Google Scholar 

  77. Chattipakorn N, Incharoen T, Kanlop N, Chattipakorn S (2007) Heart rate variability in myocardial infarction and heart failure. Int J Cardiol 120:289–296. doi:10.1016/j.ijcard.2006.11.221

    PubMed  Google Scholar 

  78. Kingwell BA, Thompson JM, Kaye DM, McPherson GA, Jennings GL, Esler MD (1994) Heart rate spectral analysis, cardiac norepinephrine spillover, and muscle sympathetic nerve activity during human sympathetic nervous activation and failure. Circulation 90:234–240

    PubMed  CAS  Google Scholar 

  79. Notarius CF, Floras JS (2001) Limitations of the use of spectral analysis of heart rate variability for the estimation of cardiac sympathetic activity in heart failure. Europace 3:29–38. doi:10.1053/eupc.2000.0136

    PubMed  CAS  Google Scholar 

  80. Chwan Ng AC, Freedman SB, Sindone AP (2007) Autonomic abnormalities in congestive heart failure patients with sleep-disordered breathing. J Card Fail 13:395–400. doi:10.1016/j.cardfail.2007.02.003

    PubMed  Google Scholar 

  81. Chen L, Shi Q, Scharf SM (2000) Hemodynamic effects of periodic obstructive apneas in sedated pigs with congestive heart failure. J Appl Physiol 88:1051–1060

    PubMed  CAS  Google Scholar 

  82. Bradley TD, Hall MJ, Ando S, Floras JS (2001) Hemodynamic effects of simulated obstructive apneas in humans with and without heart failure. Chest 119:1827–1835. doi:10.1378/chest.119.6.1827

    PubMed  CAS  Google Scholar 

  83. Bradley TD, Tkacova R, Hall MJ, Ando S, Floras JS (2003) Augmented sympathetic neural response to simulated obstructive apnoea in human heart failure. Clin Sci (Lond), 104:231–238. doi:10.1042/CS20020157

    Google Scholar 

  84. Spaak J, Egri ZJ, Kubo T et al (2005) Muscle sympathetic nerve activity during wakefulness in heart failure patients with and without sleep apnea. Hypertension 46:1327–1332. doi:10.1161/01.HYP.0000193497.45200.66

    PubMed  CAS  Google Scholar 

  85. Arias MA, Garcia-Rio F, Alonso-Fernandez A, Mediano O, Martinez I, Villamor J (2005) Obstructive sleep apnea syndrome affects left ventricular diastolic function: effects of nasal continuous positive airway pressure in men. Circulation 112:375–383. doi:10.1161/CIRCULATIONAHA.104.501841

    PubMed  Google Scholar 

  86. Yin WH, Chen JW, Jen HL et al (2004) Independent prognostic value of elevated high-sensitivity C-reactive protein in chronic heart failure. Am Heart J 147:931–938. doi:10.1016/j.ahj.2003.11.021

    PubMed  CAS  Google Scholar 

  87. Solin P, Kaye DM, Little PJ, Bergin P, Richardson M, Naughton MT (2003) Impact of sleep apnea on sympathetic nervous system activity in heart failure. Chest 123:1119–1126. doi:10.1378/chest.123.4.1119

    PubMed  Google Scholar 

  88. Doust JA, Pietrzak E, Dobson A, Glasziou P (2005) How well does B-type natriuretic peptide predict death and cardiac events in patients with heart failure: systematic review. BMJ (Clinical Research Ed.) 330:625. doi:10.1136/bmj.330.7492.625

    CAS  Google Scholar 

  89. Carmona-Bernal C, Quintana-Gallego E, Villa-Gil M, Sanchez-Armengol A, Martinez-Martinez A, Capote F (2005) Brain natriuretic peptide in patients with congestive heart failure and central sleep apnea. Chest 127:1667–1673. doi:10.1378/chest.127.5.1667

    PubMed  CAS  Google Scholar 

  90. Christ M, Sharkova Y, Fenske H et al (2007) Brain natriuretic peptide for prediction of Cheyne-Stokes respiration in heart failure patients. Int J Cardiol 116:62–69. doi:10.1016/j.ijcard.2006.03.031

    PubMed  Google Scholar 

  91. Javaheri S (2006) Acetazolamide improves central sleep apnea in heart failure: a double-blind, prospective study. Am J Respir Crit Care Med 173:234–237. doi:10.1164/rccm.200507-1035OC

    PubMed  CAS  Google Scholar 

  92. Usui K, Bradley TD, Spaak J et al (2005) Inhibition of awake sympathetic nerve activity of heart failure patients with obstructive sleep apnea by nocturnal continuous positive airway pressure. J Am Coll Cardiol 45:2008–2011. doi:10.1016/j.jacc.2004.12.080

    PubMed  Google Scholar 

  93. Mansfield DR, Gollogly NC, Kaye DM, Richardson M, Bergin P, Naughton MT (2004) Controlled trial of continuous positive airway pressure in obstructive sleep apnea and heart failure. Am J Respir Crit Care Med 169:361–366. doi:10.1164/rccm.200306-752OC

    PubMed  Google Scholar 

  94. Gilman MP, Floras JS, Usui K, Kaneko Y, Leung RS, Bradley TD (2008) Continuous positive airway pressure increases heart rate variability in heart failure patients with obstructive sleep apnoea. Clin Sci (Lond) 114:243–249. doi:10.1042/CS20070172

    Article  Google Scholar 

  95. Hunt SA, Abraham WT, Chin MH et al (2005) ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult–summary article: a report of the American College of Cardiology/American Heart Association task force on practice guidelines (writing committee to update the 2001 guidelines for the evaluation and management of heart failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation 112:1825–1852. doi:10.1161/CIRCULATIONAHA.105.167587

    Google Scholar 

  96. Sin DD, Fitzgerald F, Parker JD et al (2003) Relationship of systolic BP to obstructive sleep apnea in patients with heart failure. Chest 123:1536–1543. doi:10.1378/chest.123.5.1536

    PubMed  Google Scholar 

  97. Kaneko Y, Floras JS, Usui K et al (2003) Cardiovascular effects of continuous positive airway pressure in patients with heart failure and obstructive sleep apnea. N Engl J Med 348:1233–1241

    PubMed  Google Scholar 

  98. Tkacova R, Dajani HR, Rankin F, Fitzgerald FS, Floras JS, Bradley TD (2000) Continuous positive airway pressure improves nocturnal baroreflex sensitivity of patients with heart failure and obstructive sleep apnea. J Hypertens 18:1257–1262. doi:10.1097/00004872-200018090-00012

    PubMed  CAS  Google Scholar 

  99. Yoshinaga K, Burwash IG, Leech JA et al (2007) The effects of continuous positive airway pressure on myocardial energetics in patients with heart failure and obstructive sleep apnea. J Am Coll Cardiol 49:450–458. doi:10.1016/j.jacc.2006.08.059

    PubMed  Google Scholar 

  100. McKie PM, Burnett JC Jr (2005) B-type natriuretic peptide as a biomarker beyond heart failure: speculations and opportunities. Mayo Clin Proc 80:1029–1036

    PubMed  CAS  Google Scholar 

  101. Svatikova A, Shamsuzzaman AS, Wolk R, Phillips BG, Olson LJ, Somers VK (2004) Plasma brain natriuretic peptide in obstructive sleep apnea. Am J Cardiol 94:529–532. doi:10.1016/j.amjcard.2004.05.010

    PubMed  CAS  Google Scholar 

  102. Smith LA, Vennelle M, Gardner RS et al (2007) Auto-titrating continuous positive airway pressure therapy in patients with chronic heart failure and obstructive sleep apnoea: a randomized placebo-controlled trial. Eur Heart J 28:1221–1227. doi:10.1093/eurheartj/ehm131

    PubMed  Google Scholar 

  103. Cleland JG, Daubert JC, Erdmann E et al (2005) The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med 352:1539–1549. doi:10.1056/NEJMoa050496

    PubMed  CAS  Google Scholar 

  104. Stanchina ML, Ellison K, Malhotra A et al (2007) The impact of cardiac resynchronization therapy on obstructive sleep apnea in heart failure patients: a pilot study. Chest 132:433–439. doi:10.1378/chest.06-2509

    PubMed  Google Scholar 

  105. Oldenburg O, Faber L, Vogt J et al (2007) Influence of cardiac resynchronisation therapy on different types of sleep disordered breathing. Eur J Heart Fail 9:820–826. doi:10.1016/j.ejheart.2007.03.009

    PubMed  Google Scholar 

  106. Granton JT, Naughton MT, Benard DC, Liu PP, Goldstein RS, Bradley TD (1996) CPAP improves inspiratory muscle strength in patients with heart failure and central sleep apnea. Am J Respir Crit Care Med 153:277–282

    PubMed  CAS  Google Scholar 

  107. Sin DD, Logan AG, Fitzgerald FS, Liu PP, Bradley TD (2000) Effects of continuous positive airway pressure on cardiovascular outcomes in heart failure patients with and without Cheyne-Stokes respiration. Circulation 102:61–66

    PubMed  CAS  Google Scholar 

  108. Kasai T., Narui K., Dohi T et al (2005). Efficacy of nasal bi-level positive airway pressure in congestive heart failure patients with Cheyne-Stokes respiration and central sleep apnea. Circ J 69:913–921. doi:10.1253/circj.69.913

    PubMed  Google Scholar 

  109. Pepperell JC, Maskell NA, Jones DR et al (2003) A randomized controlled trial of adaptive ventilation for Cheyne-Stokes breathing in heart failure. Am J Respir Crit Care Med 168:1109–1114. doi:10.1164/rccm.200212-1476OC

    PubMed  Google Scholar 

  110. Javaheri S, Parker TJ, Wexler L, Liming JD, Lindower P, Roselle GA (1996) Effect of theophylline on sleep-disordered breathing in heart failure. N Engl J Med 335:562–567. doi:10.1056/NEJM199608223350805

    PubMed  CAS  Google Scholar 

  111. Andreas S, Reiter H, Luthje L et al (2004) Differential effects of theophylline on sympathetic excitation, hemodynamics, and breathing in congestive heart failure. Circulation 110:2157–2162. doi:10.1161/01.CIR.0000144356.39262.16

    PubMed  CAS  Google Scholar 

  112. Sasayama S, Izumi T, Seino Y, Ueshima K, Asanoi H (2006) Effects of nocturnal oxygen therapy on outcome measures in patients with chronic heart failure and Cheyne-Stokes respiration. Circ J 70:1–7. doi:10.1253/circj.70.1

    PubMed  Google Scholar 

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  1. Faculty of Medicine, Concord RG Hospital, The University of Sydney, Hospital Road, Concord, 2139, NSW, Australia

    Austin Chin Chwan Ng & Saul Benedict Freedman

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  1. Austin Chin Chwan Ng
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  2. Saul Benedict Freedman
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Correspondence to Austin Chin Chwan Ng.

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Dr. Ng performed the literature review and was the primary author of the manuscript. Prof. Freedman critically reviewed and co-authored the revised manuscript.

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Ng, A.C.C., Freedman, S.B. Sleep disordered breathing in chronic heart failure. Heart Fail Rev 14, 89–99 (2009). https://doi.org/10.1007/s10741-008-9096-8

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