Sleep Apnea and Heart Failure

Clinical Phenotypes in Heart Failure With Preserved Ejection Fraction

“…Independently from hypertension and obesity, OSA impairs LV diastolic function, begets LVH, and thus may hasten HFpEF progression 126, 127, 252, 253, 254, 255, 256, 257, 258. Repetitive sleep arousals and hypoxic episodes heighten sympathetic activity and promote endothelial dysfunction, systemic inflammation, and arterial stiffness that may further increase blood pressure and accelerate atherosclerosis progression 128, 259, 260, 261, 262, 263, 264, 265…”

Sleep‐disordered breathing in heart failure: facts and numbers

“…Likewise, OSA is also more prevalent in patients with HF as compared with the general population 1, 24. It is also its own risk factor for cardiovascular disease 4, 49, 50, 51. The presence of OSA fundamentally contributes to myocardial failure and earlier mortality in patients with HF 4.…”

“…It is also its own risk factor for cardiovascular disease 4, 49, 50, 51. The presence of OSA fundamentally contributes to myocardial failure and earlier mortality in patients with HF 4. Although awareness among physicians of sleep‐disordered breathing is growing, clinically significant sleep‐disordered breathing is still vastly under‐diagnosed and even available tools may be underutilized 3, 52, 53…”

“…The pre‐eminent disorders are obstructive sleep apnoea (OSA), central sleep apnoea (CSA), and mixed sleep apnoea, which presents with components of both OSA and CSA. All three forms are characterized by episodes of hypopnoea and/or apnoea, with disease severity increasing with the number of events 1, 2, 3, 4, 5. In this context, hypopnoeas are defined as a reduction in nasal flow of ≥50% for ≥10 s combined with arousal or a decline in oxygen saturation ≥4 percentage points.…”

“…This leads to a partial or complete airway obstruction, producing hypopnoeas or apnoeas, respectively. The resulting hypoxia and hypercapnia act as strong central stimulants and provoke a reacquisition of normal breathing and/or arousal 3, 4, 8, 9, 10. Patients are not usually aware of such episodes of arousal, but they still cause stress.…”