The effect of oxygen on respiration and sleep in patients with congestive heart failure

Article Abstract:

Patients with congestive heart failure are known to suffer from an insufficient supply of oxygen (hypoxemia) during sleep. Some consequences of this condition include aggravation of the existing heart condition, development of irregular breathing, and disruption of sleep. This reduction of oxygen also may lead to a periodic halt in breathing, referred to as Cheyne-Stokes respiration, which typically lasts between 10 and 60 seconds. It was hypothesized that supplemental oxygen would help relieve this symptom in these patients. A group of 11 subjects, each suffering from severe but stable congestive heart failure, were selected for two sleep study trials. Each patient was allowed to become acclimated to the sleep laboratory for one night. Although these patients had normal oxygenation while awake, they all experienced hypoxemia as they slept. In all patients, Cheyne-Stokes respiration was observed, predominantly during non-rapid eye movement (NREM) sleep. The next night four patients were given compressed air, which was followed by oxygen on the third night. The other five were given oxygen on the second night, followed by compressed air on the third night. When the subjects received the low-flow oxygen supplement, the incidence of Cheyne-Stokes respiration was reduced and patients were better able to sleep through the night. Sleep disturbances resulting from the hyperpneic phase (increased rate of respiration) of Cheyne-Stokes respiration were significantly minimized. It was concluded that supplemental oxygen is useful in reducing symptoms of oxygen desaturation typically experienced by individuals with severe stable congestive heart failure. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Hypoxia, Anoxia

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Occult sleep-disordered breathing in stable congestive heart failure

Article Abstract:

Persons being treated for stable congestive heart failure and left ventricular systolic dysfunction may experience moderate to severe sleep-disordered breathing. A study of 42 non-bedridden patients with stable, treated congestive heart failure and left ventricular ejection fractions at 45% or less found that 45% of patients had more than 26 episodes per hour of an absence of breathing (apnea) or abnormally shallow, slow breathing (hypopnea) and of excessive arousals. Disordered breathing episodes were unsuspected by doctors in many cases. The severity of left ventricular systolic dysfunction predicted periodic breathing during sleep. Obesity was a risk factor for the obstructive sleep apnea-hypopnea syndrome.

Risk factors

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Association of low PaCO2 with central sleep apnea and ventricular arrhythmias in ambulatory patients with stable heart failure

Article Abstract:

Low blood levels of carbon dioxide (CO2) during the day may predict which patients with heart failure will experience apnea during sleep. Apnea occurs when a sleeping person stops breathing for 10 seconds or more. Researchers studied 59 patients with heart failure in a sleep laboratory. Those who had low blood CO2 levels during the day were more likely to have sleep apnea and had more hourly episodes of sleep apnea. They also had more episodes of ventricular tachycardia, which is a heart arrhythmia.

Measurement, Physiological aspects, Carbon dioxide, Blood gases, Carbon dioxide in the body

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