Non-Mask-based Therapies for Central Sleep Apnea in Patients with Heart Failure

Abstract

Central sleep apnea is common in heart failure and contributes to morbidity and mortality. Symptoms are often similar to those associated with heart failure and a high index of suspicion is needed. Testing is typically done in the sleep laboratory, but home testing equipment can distinguish between central and obstructive events. Treatments are limited. Mask-based therapies have been the primary treatment. Oxygen has some data but lacks long-term studies. Neurostimulation of the phrenic nerve is a new technology that has demonstrated improvement. Coordination of care between sleep specialists and cardiologists is important as the field of central sleep apnea continues to develop.

Keywords: Acetazolamide; Cardiac resynchronization thereapy; Central sleep apnea; Heart failure; Phrenic nerve stimulation; Theophylline.