CSA Is Not Beneficial Long Term in Heart Failure Patients with Reduced Ejection Fraction

Abstract

Central sleep apnea (CSA) affects many patients, with heart failure and results in hypoxia and nor-epinephrine release and is associated with high morbidity and mortality. Recent trials in the treatment of CSA using positive airway pressure therapies have failed to demonstrate improvement in mortality and as a result, the compensatory nature of CSA has been questioned. The detrimental effects from CSA are clear. While there may be a short term compensatory effect, the long term effects cause chronic insult to the cardiovascular system indicating that CSA should be treated, but alternative treatment options need to be considered.

Keywords: central sleep apnea; compensatory mechanism; heart failure; sleep.