Skip to main content

Chronic Heart Failure and Sleep-Disordered Breathing: Evidence for the Effect of Continuous Positive Airway Pressure and Key Practical Implications

  • Chapter
Noninvasive Mechanical Ventilation
  • 3366 Accesses

Abstract

Sleep-disordered breathing (SDB) is frequently observed in patients with chronic heart failure (CHF). Although coexisting SDB promotes the progression of CHF, abolition of SDB by continuous positive airway pressure may improve long-term outcomes. Because CHF remains one of the major causes of mortality, the importance of managing SDB needs greater emphasis.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

AHI:

Apnea-hypopnea index

ASV:

Adaptive servo-ventilation

CANPAP:

Canadian Continuous Positive Airway Pressure for Treatment of Central Sleep Apnea in Heart Failure

CHF:

Chronic heart failure

CPAP:

Continuous positive airway pressure

CSA:

Central sleep apnea

CSR:

Cheyne-Stokes respiration

LV:

Left ventricular

LVEF:

Left ventricular ejection fraction

OSA:

Obstructive sleep apnea

PaCO2 :

Arterial partial pressure of carbon dioxide

REM:

Rapid eye movement

RV:

Right ventricular

SDB:

Sleep-disordered breathing

SNA:

Sympathetic nerve activity

References

  1. Kasai T, Floras JS, Bradley TD. Sleep apnea and cardiovascular disease: a bidirectional relationship. Circulation. 2012;126:1495–510.

    Article  PubMed  Google Scholar 

  2. Wang H, Parker JD, Newton GE, et al. Influence of obstructive sleep apnea on mortality in patients with heart failure. J Am Coll Cardiol. 2007;49:1625–31.

    Article  PubMed  Google Scholar 

  3. Javaheri S, Shukla R, Zeigler H, et al. Central sleep apnea, right ventricular dysfunction, and low diastolic blood pressure are predictors of mortality in systolic heart failure. J Am Coll Cardiol. 2007;49:2028–34.

    Article  PubMed  Google Scholar 

  4. Arzt M, Floras JS, Logan AG, et al. 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. 2007;115:3173–80.

    Article  PubMed  Google Scholar 

  5. Inoshita A, Kasai T, Takahashi M, et al. Craniofacial anatomical risk factors in men with obstructive sleep apnea and heart failure: a pilot study. Sleep Breath. 2014;18:439–45.

    Article  PubMed  Google Scholar 

  6. Kasai T, Bradley TD. Obstructive sleep apnea and heart failure: pathophysiologic and therapeutic implications. J Am Coll Cardiol. 2011;57:119–27.

    Article  PubMed  Google Scholar 

  7. Kasai T, Yumino D, Redolfi S, et al. Overnight effects of obstructive sleep apnea and its treatment on stroke volume in patients with heart failure. Can J Cardiol. 2015;31(7):832–8.

    Google Scholar 

  8. Arzt M, Bradley TD. Treatment of sleep apnea in heart failure. Am J Respir Crit Care Med. 2006;173:1300–8.

    Article  PubMed  Google Scholar 

  9. Tkacova R, Rankin F, Fitzgerald FS, et al. Effects of continuous positive airway pressure on obstructive sleep apnea and left ventricular afterload in patients with heart failure. Circulation. 1998;98:2269–75.

    Article  CAS  PubMed  Google Scholar 

  10. Yoshinaga K, Burwash IG, Leech JA, et al. The effects of continuous positive airway pressure on myocardial energetics in patients with heart failure and obstructive sleep apnea. J Am Coll Cardiol. 2007;49:450–8.

    Article  PubMed  Google Scholar 

  11. Hall AB, Ziadi MC, Leech JA, et al. Effects of short-term continuous positive airway pressure on myocardial sympathetic nerve function and energetics in patients with heart failure and obstructive sleep apnea: a randomized study. Circulation. 2014;130:892–901.

    Article  PubMed  Google Scholar 

  12. Kaneko Y, Floras JS, Usui K, et al. Cardiovascular effects of continuous positive airway pressure in patients with heart failure and obstructive sleep apnea. N Engl J Med. 2003;348:1233–41.

    Article  PubMed  Google Scholar 

  13. Usui K, Bradley TD, Spaak J, et al. Inhibition of awake sympathetic nerve activity of heart failure patients with obstructive sleep apnea by nocturnal continuous positive airway pressure. J Am Coll Cardiol. 2005;45:2008–11.

    Article  PubMed  Google Scholar 

  14. Egea CJ, Aizpuru F, Pinto JA, et al. Cardiac function after CPAP therapy in patients with chronic heart failure and sleep apnea: a multicenter study. Sleep Med. 2008;9:660–6.

    Article  PubMed  Google Scholar 

  15. Mansfield DR, Gollogly NC, Kaye DM, et al. Controlled trial of continuous positive airway pressure in obstructive sleep apnea and heart failure. Am J Respir Crit Care Med. 2004;169:361–6.

    Article  PubMed  Google Scholar 

  16. Smith LA, Vennelle M, Gardner RS, et al. 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. 2007;28:1221–7.

    Article  PubMed  Google Scholar 

  17. Gilman MP, Floras JS, Usui K, et al. Continuous positive airway pressure increases heart rate variability in heart failure patients with obstructive sleep apnoea. Clin Sci (Lond). 2008;114:243–9.

    Article  Google Scholar 

  18. Ruttanaumpawan P, Gilman MP, Usui K, et al. Sustained effect of continuous positive airway pressure on baroreflex sensitivity in congestive heart failure patients with obstructive sleep apnea. J Hypertens. 2008;26:1163–8.

    Article  CAS  PubMed  Google Scholar 

  19. Kasai T, Narui K, Dohi T, et al. Prognosis of patients with heart failure and obstructive sleep apnea treated with continuous positive airway pressure. Chest. 2008;133:690–6.

    Article  PubMed  Google Scholar 

  20. Naughton MT, Benard DC, Rutherford R, et al. Effect of continuous positive airway pressure on central sleep apnea and nocturnal PCO2 in heart failure. Am J Respir Crit Care Med. 1994;150:1598–604.

    Article  CAS  PubMed  Google Scholar 

  21. Naughton MT, Benard DC, Liu PP, et al. Effects of nasal CPAP on sympathetic activity in patients with heart failure and central sleep apnea. Am J Respir Crit Care Med. 1995;152:473–9.

    Article  CAS  PubMed  Google Scholar 

  22. Takasaki Y, Orr D, Popkin J, et al. Effect of nasal continuous positive airway pressure on sleep apnea in congestive heart failure. Am Rev Respir Dis. 1989;140:1578–84.

    Article  CAS  PubMed  Google Scholar 

  23. Naughton MT, Liu PP, Bernard DC, et al. Treatment of congestive heart failure and Cheyne-Stokes respiration during sleep by continuous positive airway pressure. Am J Respir Crit Care Med. 1995;151:92–7.

    Article  CAS  PubMed  Google Scholar 

  24. Granton JT, Naughton MT, Benard DC, et al. CPAP improves inspiratory muscle strength in patients with heart failure and central sleep apnea. Am J Respir Crit Care Med. 1996;153:277–82.

    Article  CAS  PubMed  Google Scholar 

  25. Tkacova R, Liu PP, Naughton MT, et al. Effect of continuous positive airway pressure on mitral regurgitant fraction and atrial natriuretic peptide in patients with heart failure. J Am Coll Cardiol. 1997;30:739–45.

    Article  CAS  PubMed  Google Scholar 

  26. Sin DD, Logan AG, Fitzgerald FS, et al. Effects of continuous positive airway pressure on cardiovascular outcomes in heart failure patients with and without Cheyne-Stokes respiration. Circulation. 2000;102:61–6.

    Article  CAS  PubMed  Google Scholar 

  27. Malone S, Liu PP, Holloway R, et al. Obstructive sleep apnoea in patients with dilated cardiomyopathy: effects of continuous positive airway pressure. Lancet. 1991;338:1480–4.

    Article  CAS  PubMed  Google Scholar 

  28. Johnson CB, Beanlands RS, Yoshinaga K, et al. Acute and chronic effects of continuous positive airway pressure therapy on left ventricular systolic and diastolic function in patients with obstructive sleep apnea and congestive heart failure. Can J Cardiol. 2008;24:697–704.

    Article  PubMed Central  PubMed  Google Scholar 

  29. Ryan CM, Usui K, Floras JS, et al. Effect of continuous positive airway pressure on ventricular ectopy in heart failure patients with obstructive sleep apnoea. Thorax. 2005;60:781–5.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  30. Ferrier KA, Neill AM, O’Meeghan T, et al. Continuous positive airway pressure in heart failure patients with obstructive sleep apnoea. Intern Med J. 2008;38:829–36.

    Article  CAS  PubMed  Google Scholar 

  31. Javaheri S. Effects of continuous positive airway pressure on sleep apnea and ventricular irritability in patients with heart failure. Circulation. 2000;101:392–7.

    Article  CAS  PubMed  Google Scholar 

  32. Davies RJ, Harrington KJ, Ormerod OJ, et al. Nasal continuous positive airway pressure in chronic heart failure with sleep-disordered breathing. Am Rev Respir Dis. 1993;147:630–4.

    Article  CAS  PubMed  Google Scholar 

  33. Arzt M, Harth M, Luchner A, et al. Enhanced ventilatory response to exercise in patients with chronic heart failure and central sleep apnea. Circulation. 2003;107:1998–2003.

    Article  PubMed  Google Scholar 

  34. Bradley TD, Logan AG, Kimoff RJ, et al. Continuous positive airway pressure for central sleep apnea and heart failure. N Engl J Med. 2005;353:2025–33.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Takatoshi Kasai MD, PhD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Kasai, T. (2016). Chronic Heart Failure and Sleep-Disordered Breathing: Evidence for the Effect of Continuous Positive Airway Pressure and Key Practical Implications. In: Esquinas, A. (eds) Noninvasive Mechanical Ventilation. Springer, Cham. https://doi.org/10.1007/978-3-319-21653-9_88

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-21653-9_88

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-21652-2

  • Online ISBN: 978-3-319-21653-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics