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Sleep Breath 2000; 04(3): 103-112
DOI: 10.1055/s-2000-11567
Copyright © 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Sleep-Breathing Disorders and Heart Failure

Stefan Thalhofer, Peter Dorow
  • Department of Respiratory and Intensive Care Medicine, DRK-Hospital Mark Brandenburg, Humboldt University of Berlin, Berlin, Germany
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Publication History

Publication Date:
31 December 2000 (online)

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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

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