Conclusions and Future Directions

↳ This is a section part of Moment: Sleep-disordered Breathing in Heart Failure

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Summary

Conclusion

SDB in HF is common, frequently undiagnosed and associated with a poor prognosis. The use of sleepiness questionnaires is not useful in HF. While polysomnography remains the gold standard test, simple screening may be performed with overnight pulse oximetry. Home polygraphy is simple to use and interpret with adequate diagnostic power in most patients. In parallel with optimal HF treatment, therapy with CPAP is likely to be of benefit for those with HF and OSA. The role of positive pressure support in CSA is unclear. ASV has many advantages in CSA and HF but this does not appear to translate in to improved clinical endpoints and it increases mortality. The long- term results of novel therapies such as phrenic nerve stimulation are awaited. Our understanding of SDB continues to evolve rapidly and there are likely to be major changes in our approach to the condition in the coming years.

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