Central Sleep Apnea in Congestive Heart Failure: Prevalence, Mechanisms, Impact, and Therapeutic Options

Shahrokh Javaheri, M.D.

Disclosures

Semin Respir Crit Care Med. 2005;26(1):44-55. 

In This Article

Terminology

I use the term periodic breathing as a pattern of breathing characterized by waxing and waning of tidal volume. Polygraphically, periodic breathing is characterized by periodic waxing and waning of naso-oral airflow and thoracoabdominal excursions. Therefore, periodic breathing encompasses a variety of breathing disorders, including obstructive and central sleep apnea.

Cheyne-Stokes breathing (CSB) is a form of periodic breathing that commonly occurs with an intervening central apnea (or hypopnea) situated between the waxing and waning arms. A distinctive feature of CSB is a long "recovery phase," which reflects a prolonged arterial circulation time, an important characteristic feature of systolic heart failure. This prolonged waxing phase of CSB distinguishes it from other forms of periodic breathing with central sleep apnea such as the idiopathic form, in which the recovery arm is abrupt and short rather than smooth and prolonged.

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