Congestive heart failure and obstructive sleep apnea
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Obstructive sleep apnea is a sleep-related breathing disorder that affects on cardiovascular function. Common complications association obstructive sleep apnea include hypertension, coronary artery disease, cardiac arrhythmias, sudden cardiac death, and heart failure.
Sleep apnea in heart failure disease
- Sleep apnea is defined as partial or complete cessation of breathing during night-time sleep, resulting in repeated arousal from sleep, oxyhemoglobin desaturation, and daytime sleepiness.
- Apnea is as complete cessation of airflow for >10 s.
- Hypopnea, or partial cessation of airflow, is defined as a 50% to 90% reduction in airflow for >10 s, and >3% decrease in oxyhemoglobin saturation (SaO2) terminated by arousal.
- The 3 types of apnea include central, obstructive, and mixed.
- Central sleep apnea (CSA) is characterized by a complete withdrawal of central respiratory drive to the inspiratory muscles, including the diaphragm, and results in the simultaneous absence of naso-oral airflow and thoracoabdominal excursions.
- In obstructive sleep apnea (OSA), the thoracic inspiratory muscles, including the diaphragm, are active, so thoracoabdominal excursions are seen.
- Absence of airflow results from upper-airway occlusion caused by lost pharyngeal dilator muscle tone, with consequent pharyngeal collapse.
- Mixed apnea has an initial central component followed by an obstructive component.
- Two types of hypopnea include [[obstructive or central.