Sleep‐disordered breathing in heart failure: facts and numbers

Abstract

Sleep‐disordered breathing has a high prevalence in the general population, but is especially prominent in patients with heart failure (HF). HF and sleep‐disordered breathing share a bidirectional relationship, with sleep‐disordered breathing being both cause and effect of poor cardiac functioning. The high inter‐individual variability of symptom presentation can impede the clinical diagnostic process. Polysomnography is the gold‐standard method of diagnosing sleep‐disordered breathing. Therapy of sleep‐disordered breathing should always consist of optimizing the treatment of the underlying disorder of HF. Additional therapeutic measures include continuous positive airway pressure ventilation therapy. New therapeutic options using neurostimulation are yielding promising results; however, long‐term benefits still need to be confirmed.

Co‐morbidities in heart failure beginning to sprout—and no end in sight?

“…26 Another co-morbidity that remains largely under-recognized and under-treated in HF is sleep disordered breathing. 27,28 Even though a large number of studies has been published in recent years, screening (polygraphy, questionnaires) and monitoring (e.g. SleepMinder TM ) 29 tools remain under-utilized.…”

Highlights in heart failure

“…101,102,188,189 The contribution of comorbidities to patients' outcomes may be similar in patients with HFrEF, compared with those with HFpEF, 189 or be larger in those with HFpEF according to other analyses. 132 The most frequent noncardiac comorbidities include chronic kidney disease, 21,32,134,[190][191][192][193] , chronic obstructive pulmonary disease, 194 central nervous system abnormalities, 195 sleep disordered breathing, 196,197 diabetes mellitus, 65,198,199 cancer, 188,200 and iron deficiency. 60,61,63,201 They were all shown to have a major impact on clinical presentation, response to treatment and outcomes.…”

Appetite in patients with heart failure: Assessment, prevalence and related factors

“…The symptoms of SDB may involve disrupted sleep, daytime sleepiness, impaired memory and concentration [54]. Sleep-disordered breathing is more prevalent in HF compared to the general population [21]. The associations between sleep disturbances and appetite are not clearly understood.…”

“…Sleep deprivation is a common problem in patients with HF and it is more prevalent compared to general populations [21]. Yet, the associations between sleep and appetite have previously not been investigated.…”

“…Heart failure with fluid overload with bowel edema and breathlessness is likely to cause decreased appetite as patients may feel full, and breathlessness makes it difficult to eat [12,13,16]. Moreover, symptoms of depression and sleep disturbances are common problems in HF populations [19][20][21], which may also play a role for decreased appetite [22,23]. Despite appetite being important for maintaining food intake and a healthy weight, there is a lack of knowledge on the significance of problems with decreased appetite in patients with HF.…”