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Sleep Breath 2000; 04(3): 103-112
DOI: 10.1055/s-2000-11567
DOI: 10.1055/s-2000-11567
Sleep-Breathing Disorders and Heart Failure
Stefan Thalhofer, Peter Dorow- Department of Respiratory and Intensive Care Medicine, DRK-Hospital Mark Brandenburg, Humboldt University of Berlin, Berlin, Germany
Further Information
Publication History
Publication Date:
31 December 2000 (online)
ABSTRACT
Cheyne-Stokes respiration is known to be associated with severe left heart failure. Because of severe desaturation, sleep fragmentation, arousals, and an increase in sympathetic activity, Cheyne-Stokes respiration may lead to a further impairment of cardiac function and to a worsening of quality of life. Although the pathology of Cheyne-Stokes respiration is not fully understood, enhanced chemoreceptor sensitivity, prolonged circulation time, as well as decreased pulmonary gas stores and increased ventilatory drive may be contributing factors. Therapeutic options include the improvement of cardiac failure; medical treatment, such as using theophylline; continous positive airway pressure ventilation; and low-flow oxygen supply. Because of severe cardiac insufficiency, change of endothoracic pressure may worsen the hemodynamic situation in some patients. Therefore, this form of treatment has to be used carefully. Another possible treatment is a low-flow oxygen supply, which will prevent severe desaturations. This therapeutic approach might be a good alternative to noninvasive ventilation. However, it is controversial whether oxygen supply will improve quality of sleep of the patients, even in long-term treatment.
KEYWORD
sleep apnea - Cheyne-Stokes respiration - chronic heart failure - dilated cardiomyopathy - congestive heart failure - oygen therapy - continous positive airway pressure (CPAP) - theophylline
REFERENCES
- 1 Yamashiro Y, Kryger M H. Sleep in heart failure. Sleep . 1993; 16 513-523
- 2 Cheyne J A. A case of apoplexy in which the fleshy part of the heart was converted into fat. Dublin Hospital Reports . 1818; 2 216-222
- 3 Stokes W. The diseases of the heart and the aorta. Dublin, Hodges and Smith 1854: 302-40
- 4 Douglas G S, Haldane J S. The causes of periodic or Cheyne-Stokes breathing. J Physiol . 1909; 38 401-419
- 5 Harrison T R, King C E, Calhoun J A, Harrison Jr G W. Congestive heart failure: Cheyne-Stokes respiration as a cause of paroxysmal dyspnea at the onset of sleep. Arch Intern Med . 1934; 53 891-910
- 6 Greene J A. Clinical studies of respiration: some observations on Cheyne-Stokes respiration. Arch Intern Med . 1934; 52 454-463
- 7 Biot C. Etude Clinique et Experimental sur La Respiration de Cheyne-Stokes. Paris: JB Baillie 1878
- 8 Marckwald M. The Movements of Respiration and Their Innervation in The Rabbit. London: Blackie & Son 1888
- 9 Eyster J AE. Clinical and experimental observations upon Cheyne-Stokes respiration. J Exp Med . 1906; 8 565-613
- 10 Grimmer R V, Hesser F H, Longworthy O R. Rhythmic variation of respiratory excursions with bilateral injury of cortical efferent fibers. Arch Neurol Psychiatry . 1939; 42 862-871
- 11 Findley L J, Zwillich C W, Ancoli-Israel S, Kripke D, Tisi G, Moser K M. Cheyne-Stokes breathing during sleep in patients with left ventricular heart failure. South Med J . 1985; 78 11-15
- 12 Hanly P J, Fillar T WN, Steljes D G, Baert R, Frais M A, Kryger M H. Respiration and abnormal sleep in patients with congestive heart failure. Chest . 1989; 96 480-488
- 13 Thalhofer S, Dorow P, Schüler S, Hetzer R. Sauerstoffsättigung und Schlafarchitektur bei Patienten mit dilatativer Kardiomyopathie. Pneumologie . 1991; 5 259-260
- 14 Dowell A R, Buckley C E, Cohen R, Whalen R E, Sieker H O. Cheyne-Stokes respiration. A review of clinical manifestations and critique of physiological mechanisms. Arch Intern Med . 1971; 127 712-726
- 15 Lieber C V, Mohsenin V. Cheyne-Stokes respiration in congestive heart failure. Yale J Biol Med . 1992; 65 39-50
- 16 Andreas S, Breska B, Siegener M S, Figulla H R, Kreuzer H. Respiration during sleep in patients with ideopathic dilated cardiomyopathy [abstract]. Am Rev Respir Dis . 1992; 145 A446
- 17 Dowdell W T, Javaheri S, McGinnis W. Cheyne-Stokes respiration presenting as sleep apnea syndrome. Am Rev Respir Dis . 1990; 141 871-879
- 18 Hanly P J, Millar T W, Steljes D G, Baert R, Frais M A, Kryger M H. Respiration and abnormal sleep in patients with congestive heart failure. Chest . 1989; 96 480-488
- 19 Yasuma F, Nomura H, Hayashi H, Okada T, Tsuzuki M. Breathing abnormalities during sleep in patients with chronic heart failure. Jpn Circ J . 1989; 1 506-510
- 20 Takasaki Y, Orr D, Popkin J, Rutherford R, Liu P P, Bradley T D. Effect of nasal continuous positive airway pressure on sleep apnea in congestive heart failure. Am Rev Respir Dis . 1989; 140 1578-1584
- 21 Malone S, Liu P P, Holloway R, Rutherford R, Xie A, Bradley T D. Obstructive sleep apnoea in patients with dilated cardiomyopathy effects of continuous positive airway pressure. Lancet . 1991; 338 1480-1484
- 22 Alex C, Önal E, Lopata M. Upper airway occlusion during sleep in patients with Cheyne-Stokes respiration. Am Rev Respir Dis . 1986; 133 42-45
- 23 Campbell E JM, Howell J B. Proprioceptive control of breathing. In: de Rüch AUS, O'Connor M, eds. Ciba Foundation Symposium on Pulmonary Structure and Function Edinburgh: Churchill Livingstone; 1962
- 24 Berger A J. Control of respiration. In: Physiology and Biophysics Philadelphia: WB Saunders 1987
- 25 Klein O. Untersuchungen über das Cheyne-Stokesche Atmungsphänomen. Desch Ges Inn Med . 1930; 42 217
- 26 Naughton M, Benard D, Tam A, Rutherford R, Bradley T D. Role of hyperventilation in the pathogenesis of central sleep apneas in patients with congestive heart failure. Am Rev Respir Dis . 1993; 148 330-338
- 27 Millar T W, Hanly P J, Hunt B, Frais M, Kryger M H. The entrainment of low frequency breathing periodicity. Chest . 1990; 98 1143-1148
- 28 Guyton A C, Crowell J W, Moore J W. Basic oscillating mechanism of Cheyne-Stokes breathing. Am J Physiol . 1956; 187 395-398
- 29 Lange R L, Hecht H H. The mechanism of Cheyne-Stokes respiration. J Clin Invest . 1962; 41 42-52
- 30 Weil J V, Kryger M H, Scoggin C. Sleep and breathing at high altitude. In: Guilleminault CW, Dement C, eds. Sleep Apnea Syndomes New York:Alan R. Liss, 1978: 119-135
- 31 Bradley T D, Holloway R M, McLaughin P R, Ross B L, Walters J, Liu P P. Cardiac output response to continous positive airway pressure in congestive heart failure. Am Rev Respir Dis . 1992; 145 377-382
- 32 Reed J W, Ablett M, Cotes J E. Ventilatory responses to exercises and to carbon dioxide in mitral stenosis before and after valvulotomy: causes of tachypnoea. Clin Sci Mol Med . 1978; 54 9-15
- 33 Bradley T D, Floras J S. Pathophysiology and therapeutic implications of sleep anea in congestive heart failure. J Card Fail . 1996; 2 223-240
- 34 Ambrosino N, Opasich C, Crotti P, Cobelli F, Tavazzi L, Rampulla C. Breathing pattern, ventilatory drive and respiratory muscle strength in patients with chronic heart failure. Eur Respir J . 1994; 7 17-22
- 35 Sullivan M, Higgenbottam M, Cobb F. Increased exercise ventilation in patients with chronic heart failure: intact ventilatory control despite hemodynamic and pulmonary abnormalities. Circulation . 1988; 77 552-559
- 36 Altschule M D, Iglauer A. The effect of portion on peridic breathing in chronic cardiac decompensation. N Engl J Med . 1958; 27 1064-1066
- 37 Massumi R, Nutter D. Cardiac arrhythmias associated with Cheyne-Stokes respiration. J Dis Chest . 1968; 54 21-32
- 38 Maze S, Kotler M N, Parry W R. Doppler evaluation of changing cardiac dynamics during Cheyne-Stokes respiration. Chest . 1989; 95 525-529
- 39 Javaheri S, Parker T J, Liming J D. Sleep apnea in 81 ambulatory male patients with stable heart failure. Circulation . 1998; 97 2154-2159
- 40 Bradley T D. Right and left ventricular functional impairment and sleep apnea. Clin Chest Med . 1992; 13 459-479
- 41 Lanfranchi P A, Bragholi A, Bosimini E, Mazzuero G, Colombo R, Donner C F. Prognostic value of nocturnal Cheyne-Stokes respiration in chronic heart failure. Circulation . 1999; 11 1435-1440
- 42 Hoffman R, Agatston A, Krieger B. Cheyne-Stokes respiration in patients recovering from acute cardiogenic pulmonary edema. Chest . 1990; 97 410-412
- 43 Findley L J, Zwillich C W, Ancoli-Israel S, Kripke D, Tisi G, Moser K M. Cheyne-Stokes breathing during sleep in patients with left ventricular heart failure. South Med J . 1985; 78 11-15
- 44 Baylor P, Tayloe D, Owen D, Sanders C. Cardiac failure presenting as sleep apnea. Elimination of apnea following medical management of cardiac failure. Chest . 1988; 94 1298-1300
- 45 Crabb J E, Pingleton S K, Gollub S. Sleep disordered breathing (SDB) in decompensated and compensated congestive heart failure [abstract]. Am Rev Respir Dis . 1985; 131 A104
- 46 Dark D S, Pingleton S K, Kerby G R. Breathing pattem abnormalities and arterial oxygen desaturation during sleep in the congestive heart failure syndrome. Chest . 1987; 91 833-836
- 47 Bittar G, Friedman H S. The arrhythrogenicity of theophylline. A multivariate analysis of clinical determinants. Chest . 1991; 99 1415-1420
- 48 Guilleminault C, Clerk A, Labanowski M, Simmons J, Stoohs R. Cardiac failure and benzodiazepines. Sleep . 1993; 16 524-528
- 49 Biberdorf D J, Steens R, Millar T W, Kryger M H. Benzodiazepines in congestive heart failure: effects of temazepam on arousability and Cheyne-Stokes respiration. Sleep . 1993; 16 529-538
- 50 Andreas S, Plopck E H, Heindl S, Scholz K. Nasal oxygen effects on arterial carbon dioxide pressure and heart rate in chronic heart failure. Am J Cardiol . 1999; 83 795-798
- 51 Hardy J C, Gray K, Whistler S, Leuenberger U. Sympathetic and blood pressure responses to voluntary apnea are augmented by hypoxemia. J Appl Physiol . 1994; 77 2360-2365
- 52 Lahiri S, Mokashi A, Mulligan E, Nishino T. Comparison of aortic and carotic chemoreceptors response to hypercapnia and hyperoxia. J Appl Physiol . 1981; 51 55-61
- 53 Seals D R, Johnson D G, Fregosi R F. Hyperoxia lowers sympathetic activity at rest but not during exercise in humans. Am J Physiol . 1991; 260 873-878
- 54 Dorow P, Thalhofer S, Schüler S, Hetzer R. Einfluβ der nasalen Überdruckbeatmung bei Patienten mit dilatativer Kardiomyopathie (NYHA III-IV). Pneumologie . 1993; 47 780-781
- 55 Naughton M T, Liu P P, Bernard D C, Goldstein R S, Bradley T D. Treatment of congestive heart failure and Cheyne-Stokes respiration during sleep by continous positive airway pressure. Am J Respir Crit Care Med . 1995; 151 92-97
- 56 Davies R J, Harrington K J, Ormerod O J, Stradling J R. Nasal continous positive airway pressure in chronic heart failure with sleep-disordered breathing. Am J Respir Crit Care Med . 1993; 147 630-634
- 57 Thalhofer S, Dorow P. Influence of nasal positive pressure ventilation on hemodynamics in patients with severe dilatative cardiomyopathy (NYHA III-IV). Sleep breathing . 1996; 1 9-14
- 58 Baratz D M, Westbrook P R, Shah P K, Mohsenifar Z. Effect of nasal continuous positive airway pressure on cardiac output and oxygen delivery in patients with congestive heart failure. Chest . 1992; 102 1397-1401
- 59 Javaheri S. Effects of continous positive airway pressure on sleep apnea and ventricular irritability in patients with heart failure. Circulation . 2000; 101 392-397
- 60 Naughton M T, Bernard D C, Liu P P, Rutherford R, Rankin F, Bradley T D. Effects of nasal CPAP on sympathetic activity in patients with heart failure and central sleep apnea. Am J Respir Crit Care Med . 1995; 152 473-479
- 61 Tkacova R, Liu P P, Naughton M T, Bernard D C, Bradley T D. Effects of continous positive airway pressure on atrial natriuretic peptide and mitral regurgitant fraction in patients with heart failure and central sleep apnea. J Am Coll Cardiol . 1997; 30 739-745
- 62 Steens R D, Biberdorf D, Buckle P, Ahmed M, Millar T, Kryger M H. Effect of inhaled 3%CO2 on Cheyne-Stokes respiration in congestive heart failure [abstract]. Am Rev Respir Dis . 1992; 145 A445