Sleep duration and architecture during ASV for central sleep apnoea in systolic heart failure

This study investigated changes in sleep architecture during ASV treatment in HFrEF patients.MethodsA retrospective analysis of polysomnographic datasets for 30 ASV-treated patients with stable HFrEF and moderate-to-severe CSA was performed, including blinded analyses of total sleep time (TST), and percentage of REM and non-REM sleep (stages N1-N3).ResultsFollow-up was 109 ± 32 days; mean device usage was 6.0 ± 1.1 h/day. During ASV there was reduction of N1 (34 ± 20%/TST to 13 ± 5%/TST, p 
Source: Respiratory Physiology and Neurobiology - Category: Respiratory Medicine Source Type: research

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We present a case of a patient with heart failure and CSA who underwent placement of a phrenic nerve stimulator and subsequently a left ventricular assist device (LVAD).
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Tags: 315 Source Type: research
CONCLUSION: Treatment of OSA in patients with systolic HF improves respiratory indices but does not have a favorable effect on sleep quality. While OSA per se was associated with an increase in sympathetic drive, APAP treatment was not associated with a reduction in sympathetic drive. After 6 months of treatment, there was even a trend towards additional increases in sympathetic drive in the APAP group. PMID: 31240541 [PubMed - as supplied by publisher]
Source: Sleep and Breathing - Category: Sleep Medicine Authors: Tags: Sleep Breath Source Type: research
ConclusionTreatment of OSA in patients with systolic HF improves respiratory indices but does not have a favorable effect on sleep quality. While OSA per se was associated with an increase in sympathetic drive, APAP treatment was not associated with a reduction in sympathetic drive. After 6  months of treatment, there was even a trend towards additional increases in sympathetic drive in the APAP group.
Source: Sleep and Breathing - Category: Respiratory Medicine Source Type: research
Periodic breathing (PB) during exercise is a slow, prominent, consistent fluctuation in ventilation and derived parameters that may be persistent for the entire exercise or present only in the early phases of exercise. It is associated with a negative prognosis, particularly if concomitant with PB during sleep. Little is known about exercise-induced PB physiology, but hyperventilation is likely due to an increased sympathetic activity combined with an enhanced stimulation of intrapulmonary, chemoreceptors and metaboreceptors, low cardiac output leading to increased circulatory delay, and cerebrovascular reactivity to CO2, ...
Source: Clinics in Chest Medicine - Category: Respiratory Medicine Authors: Source Type: research
We examine recent findings that have revealed interdependence of function within the chemoreceptor pathway regulating breathing and sympathetic vasomotor activity and the hypersensitization of these reflexes in chronic disease states. Recommendations are made as to how these states of hyperreflexia in chemoreceptors and muscle afferents might be modified in treating sleep apnea, drug-resistant hypertension, chronic heart failure –induced sympathoexcitation, and the exertional dyspnea of chronic obstructive pulmonary disease.
Source: Clinics in Chest Medicine - Category: Respiratory Medicine Authors: Source Type: research
Cheyne-Stokes respiration (CSR) - a type of periodic breathing characterised by periods of hyperventilation (crescendo-decrescendo pattern) that alternate with central apneas - is highly prevalent in patients with systolic heart failure (HF) [1 –3]. CSR has been hypothesised to further increase sympathetic drive and stroke volume, thus exerting detrimental effects if left untreated [4]. At least, this is what most people thought prior to publication of the SERVE-HF trial in 2015 [5]. This trial enrolled more than 1300 patients with systo lic HF and central sleep apnea who were randomly assigned to adaptive servo-vent...
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Editorial Source Type: research
Conclusion The Classification Angle (ClassA) framework has been introduced to accurately capture stress-specific dynamics of the autonomic nervous system using heart rate variability (HRV). This has been achieved based on a second-order-difference-plot of HRV, which makes it possible to assess cardiac dynamics. The framework has been shown to identify which branch of the autonomic nervous system is dominating, without inheriting any of the controversies associated with the low- and high- frequency components of HRV. The Classification Angle framework is comprehensive and has been designed to produce four metrics to assess...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
The objective of this review is to incorporate recent advances in the field into a phenotype-based approach to the management of OSA in HF. PMID: 31047953 [PubMed - as supplied by publisher]
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
Sara AlMarabeh, Mohammed H. Abdulla and Ken D. O'Halloran* Department of Physiology, School of Medicine, College of Medicine and Health, University College Cork, Cork, Ireland Renal sensory nerves are important in the regulation of body fluid and electrolyte homeostasis, and blood pressure. Activation of renal mechanoreceptor afferents triggers a negative feedback reno-renal reflex that leads to the inhibition of sympathetic nervous outflow. Conversely, activation of renal chemoreceptor afferents elicits reflex sympathoexcitation. Dysregulation of reno-renal reflexes by suppression of the inhibitory refle...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
This study had a large sample size and obtained positive findings in both patients’ subjective ratings and in inflammatory marker levels. It demonstrates the benefits of adding Tai Chi to an antidepressant regimen but does not examine the specific effect of Tai Chi on depression.Field et al. (16) investigated the effects of combined Tai Chi/yoga in 92 prenatally depressed pregnant women. They found that women practicing Tai Chi/yoga (20 min per week for 12 weeks) had lower depression, anxiety, and sleep disturbance scores compared to a waitlist control group (Table 1). This study had a large sample size and provided ...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
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