Just a quick short article on central sleep apnea and heart failure. One small 1998 study reported a drop in blood flow in the brain during episodes of obstructive hypopnea (slow and shallow breathing associated with snoring). This may also increase the risk of stroke. Such declines in blood flow did not appear to occur with obstructive or central sleep apnea, however.
Connection Between Heart Failure and Central Sleep Apnea
Here on the picture are the mechanisms that underlie periodic oscillations in ventilation in HF. Unlike OSA, central sleep apnea likely arises as a consequence of heart failure. (This picture was found on this central sleep apnea and heart failure report)
Heart failure patients with CSA typically exhibit a form of periodic breathing, known as Cheyne-Stokes respiration (CSR), and these patients have been shown to have a very poor prognosis. And there is an increased mortality associated with Cheyne-Stokes respiration in patients with congestive heart failure.
Studies have reported that between 11% and 37% of heart failure patients also have sleep apnea. Central sleep apnea is particularly linked with heart failure. The evidence for the association between heart failure and sleep apnea is suggested by the following:
- High blood pressure, which is associated with sleep apnea, is a major cause of later heart failure.
- Sleep apnea may directly contribute to the progression of heart failure by reducing oxygen levels and causing abnormal changes in blood pressure and heart rate that add to the burden of the failing heart.
In any case, obstructive sleep apnea can affect breathing functions in a way that may be particularly harmful for patients with existing congestive heart failure. A 1999 study, in fact, indicated that sleep apnea is associated with poorer survival in patients with heart failure. Some evidence suggests that treating sleep apnea with continuous positive airway pressure (CPAP) may improve heart function in these patients.
Central Sleep Apnea Website
Please also see other articles on our Central Sleep Apnea website.
