Sleep medicine
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Editorial Comment Comparative Study
The promises of meta-analyses in current RLS research: is 1+1 more than 2?
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Randomized Controlled Trial Multicenter Study
Cardiac function after CPAP therapy in patients with chronic heart failure and sleep apnea: a multicenter study.
Continuous positive airway pressure (CPAP) is an effective treatment for sleep apnea (SA), although the evidence for improving chronic heart failure (CHF) is inconclusive. Our aim was to evaluate the effect of CPAP treatment on the left ventricle ejection fraction (LVEF) among other cardiological variables in a randomized, multicenter, placebo (sham-CPAP)-controlled study. ⋯ CPAP therapy proved to be useful in patients with associated sleep-disordered breathing and CHF. The improvement was more marked in patients with a LVEF>30%. However, the increased LVEF in the CPAP group was not accompanied by changes in the other cardiological variables.
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Randomized Controlled Trial
Bi-level positive pressure ventilation and adaptive servo ventilation in patients with heart failure and Cheyne-Stokes respiration.
Nocturnal positive pressure ventilation (PPV) has been shown to be effective in patients with impaired left ventricular ejection fraction (LVEF) and Cheyne-Stokes respiration (CSR). We investigated the effect of a bi-level PPV and adaptive servo ventilation on LVEF, CSR, and quantitative sleep quality. ⋯ Administration of PPV can successfully attenuate CSA. Reduced CSA may be associated with improved LVEF; however, this may depend on the mode of PPV. Changed LVEF is evident even in the absence of significant changes in blood pressure.
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Nocturnal cardiac arrhythmias occur in patients with obstructive sleep apnea (OSA), reportedly as a consequence of the autonomic effects of recurrent apnea with subsequent oxygen desaturation. We have investigated whether different patterns of OSA are associated with specific arrhythmia during sleep. ⋯ We conclude that while BA during sleep is associated with OSA severity, concomitant COPD or beta(2)-treatment may play a role in the development of TA during sleep.