Obstructive Sleep Apnea (OSA) is common in patients with heart failure. This is not surprising since many of the common causes of heart failure share risk factors with obstructive sleep apnea (OSA).
Conditions seen that may be found in both heart failure and OSA:
(1) obesity
(2) diabetes mellitus
(3) hypertension
(4) dysplipidemia
(5) cardiac arrhythmias
Features of OSA that may worsen heart failure:
(1) increased sympathetic activity
(2) general fatigue, which makes exercise and good health practices difficult
Untreated obstructive sleep apnea in a patient with heart failure is associated with a worse prognosis.
Factors in chronic heart failure associated with a high risk of mortality (Lanfranchi et al):
(1) apnea/hypopnea index (AHI) >= 30 per hour
(2) left atrial area >= 25 square cm
Effective management of obstructive sleep apnea can lead to improvement in cardiac function. All patients with heart failure should be screened for OSA.
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