All You Need Is Sleep: the Effects of Sleep Apnea and Treatment Benefits in the Heart Failure Patient.

Recognition and treatment of sleep apnea is an important but easily overlooked aspect of care in the heart failure patient. This review summarizes the data behind the recommendations in current practice guidelines and highlights recent developments in treatment options. Neuromodulation using hypoglossal nerve stimulation has been increasingly used for treatment of OSA; however, it has not been studied in the heart failure population. Alternatively, phrenic nerve stimulation for treatment of CSA is effective for heart failure patients, and cardiac resynchronization therapy can be effective in improving CSA in pacing-induced cardiomyopathy. In patients suspected to have sleep apnea, polysomnography is recommended to better understand the prognosis and treatment options. Positive airway pressure is the standard treatment for sleep apnea; however, neurostimulation can be especially effective in those with predominantly central events. Understanding the pathophysiology of sleep apnea can guide further management decisions.