Title:Disturbed Sleep is Not Good for the Heart: A Narrative Review
Volume: 19
Issue: 3
Author(s): Meet Patel*, Harshani Yarlagadda, Shubekshya Upadhyay, Ritesh Neupane, Umer Qureshi, Joseph D. Raco, Rahul Jain and Rohit Jain
Affiliation:
- Department of Internal Medicine, Tianjin Medical University, Tianjin, P.R. China
Keywords:
Obstructive sleep apnea/pathophysiology, apnea-hypopnea index, congestive heart failure, continuous airway positive pressure, mandibular advancement device, hypoglossal nerve stimulation.
Abstract: Sleep-related breathing disorders, including obstructive sleep apnea (OSA) and central
sleep apnea (CSA), have a major impact on cardiovascular function. It has shown an association
with hypertension, coronary artery disease, cardiac arrhythmias, sudden cardiac death, and congestive
heart failure (CHF). This review focuses on highlighting the relationship between sleep apnea
and CHF. We discuss the underlying pathophysiology, which involves the mechanical, neurohormonal,
and inflammatory mechanisms; in addition, the similarities and differentiating clinical features
of OSA in patients with CHF and without CHF. We have also discussed several treatment
strategies, including weight loss, continuous positive airway pressure (CPAP), supplemental oxygen
therapy, theophylline, acetazolamide, mandibular advancement device, and hypoglossal nerve
stimulation (HGNS). We conclude that since there are several overlapping clinical features in patients
with OSA with Heart Failure (HF) and without HF, early detection and treatment are crucial
to decrease the risk of HF, coronary artery disease, and stroke.