Abstract:We investigated the relationship between sleep-disordered breathing (SDB) and Cheyne-Stokes respiration (CSR) while awake as well as mortality. Eighty-nine consecutive outpatients (29 females) with congestive heart failure (CHF; left ventricular ejection fraction, LVEF <45%) were prospectively evaluated. The presence of SDB and of CSR while awake before sleep onset was investigated by polysomnography. SDB prevalence was 81 and 56%, using apnea-hypopnea index cutoffs >5 and >15, respectively. CHF etiologies wer… Show more
“…However, after adjusting confounding factors such as age and NYHA functional class, untreated SA (OSA or CSA) has no significant impact on mortality in CHF. These observations were consistent with some previous studies [3][4][5], but conflict with others [6][7][8][9]. After further analyzing these studies, we found that the sample size, study population, end points, statistical tests, etc.…”
“…However, after adjusting confounding factors such as age and NYHA functional class, untreated SA (OSA or CSA) has no significant impact on mortality in CHF. These observations were consistent with some previous studies [3][4][5], but conflict with others [6][7][8][9]. After further analyzing these studies, we found that the sample size, study population, end points, statistical tests, etc.…”
“…It is now recognized that sleep apnea (SA) is very common among patients with congestive heart failure (CHF) [1][2][3][4]. Obstructive and central SA occur in approximately 25% to 37% and 27% to 38% of the CHF patients, respectively [1][2][3][4].…”
Section: Introductionmentioning
confidence: 99%
“…Obstructive and central SA occur in approximately 25% to 37% and 27% to 38% of the CHF patients, respectively [1][2][3][4]. There is also evidence that SA is associated with increased risk of cardiovascular morbidity and mortality in patients with CHF [5,6].…”
Patients with CHF and SA present a reduced and blunted cardiac autonomic modulation across the 24-hour period. These findings may help to explain the increased cardiovascular risk in patients with CHF and SA.
“…Some recent studies also suggest that daytime PB is associated with a poor prognosis, whereas other studies showed conflicting results [41,44]. Such conflicting results may be explained by the differences of situation and tools used to detect daytime PB across the studies (Table 1).…”
Section: Prognostic Impact and Treatment Optionsmentioning
confidence: 99%
“…One report showed a circadian variation of frequency of PB with three peaks (at 4:00 am, 2:00 pm, and 6:00 pm). PB was less frequently observed in the daytime (approximately one fourth of that in the nighttime) [ [44].…”
Section: Clinical Manifestations and Proposed Pathogenesismentioning
In patients with heart failure (HF), altered breathing patterns, including periodic breathing, Cheyne-Stokes breathing, and oscillatory ventilation, are seen in several situations. Since all forms of altered breathing cause similar detrimental effects on clinical outcomes, they may be considered collectively as an "altered breathing syndrome." Altered breathing syndrome should be recognized as a comorbid condition of HF and as a potential therapeutic target. In this review, we discuss mechanisms and therapeutic options of altered breathing while sleeping, while awake at rest, and during exercise.
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