ABSTRACT
Cheyne-Stokes respiration is known to be associated with severe left heart failure.
Because of severe desaturation, sleep fragmentation, arousals, and an increase in
sympathetic activity, Cheyne-Stokes respiration may lead to a further impairment of
cardiac function and to a worsening of quality of life. Although the pathology of
Cheyne-Stokes respiration is not fully understood, enhanced chemoreceptor sensitivity,
prolonged circulation time, as well as decreased pulmonary gas stores and increased
ventilatory drive may be contributing factors. Therapeutic options include the improvement
of cardiac failure; medical treatment, such as using theophylline; continous positive
airway pressure ventilation; and low-flow oxygen supply. Because of severe cardiac
insufficiency, change of endothoracic pressure may worsen the hemodynamic situation
in some patients. Therefore, this form of treatment has to be used carefully. Another
possible treatment is a low-flow oxygen supply, which will prevent severe desaturations.
This therapeutic approach might be a good alternative to noninvasive ventilation.
However, it is controversial whether oxygen supply will improve quality of sleep of
the patients, even in long-term treatment.
KEYWORD
sleep apnea - Cheyne-Stokes respiration - chronic heart failure - dilated cardiomyopathy
- congestive heart failure - oygen therapy - continous positive airway pressure (CPAP)
- theophylline
