Article

A Review of Sleep Apnoea and its Treatment in Cardiovascular Disease - An important Intervention in Cardiology?

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Keywords

Cardiovascular disease, heart failure, hypertension, atrial fibrillation, coronary artery disease, sleep-disordered breathing, obstructive sleep apnoea, cheyne-stokes-respiration, central sleep apnoea, continuous positive airway pressure, adaptive servo-ventilation,

Disclosure:Holger Woehrle supervises a sleep apnoea study in heart failure that is financed by ResMed. The remaining authors have no conflicts of interest to declare.

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DOI:https://doi.org/10.15420/ecr.2012.8.3.219

Copyright Statement:

The copyright in this work belongs to Radcliffe Medical Media. Only articles clearly marked with the CC BY-NC logo are published with the Creative Commons by Attribution Licence. The CC BY-NC option was not available for Radcliffe journals before 1 January 2019. Articles marked ‘Open Access’ but not marked ‘CC BY-NC’ are made freely accessible at the time of publication but are subject to standard copyright law regarding reproduction and distribution. Permission is required for reuse of this content.

Abstract

Sleep-disordered breathing (SDB) is a common finding in patients with cardiovascular disease (CVD). SDB can cause negative effects on the cardiovascular system and can contribute to the worsening of the underlying disease. Obstructive sleep apnoea (OSA) is a major independent risk factor for the manifestation and progression of cardiovascular diseases, whereas central sleep apnoea (CSA) and Cheyne-Stokes respiration (CSR) is a common finding in patients with advanced heart failure (HF), possibly leading to further progression. Therapy of SDB can reduce the risk of development and progression of cardiovascular diseases. Continuous positive airway pressure (CPAP) is the treatment of choice for OSA, which has been shown to reduce morbidity and mortality. Adaptive servo-ventilation (ASV) is currently the most effective treatment modality in patients with CSA/CSR and in HF patients, which leads to an improvement of symptoms, but still awaits its evaluation on patients' prognosis (currently being tested in a large randomised clinical trial). It has to be noted that the beneficial effects for both treatment modalities are strongly dependent on adequate adherence.

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