Sleep Apnea & CHF

In any group of friends, we all have a buddy with whom no one wants to share a hotel room on road trips.  Why?  Because s/he saws logs with enough enthusiasm to raise the dead, like the proverbial freight train rolling through your bedroom.  These days, we know snoring isn't all fun & games.  Luckily, not everyone who snores has sleep apnea.  But the vast majority of those w/sleep apnea do in fact snore.

And they feel miserable when they wake up, after a night of non-refreshing sleep due to too numerous to count micro-arousals.  So they never drift into deep enough sleep to release growth hormone.  As if this weren't bad enough, they also increase their risk for cardiac dysrhythmias, hypertension, pulmonary hypertension, heart failure and even sudden cardiac death.

The solution is often easier to prescribe than it is to comply:  continuous positive airway pressure or CPAP.  Basically, this uses air pressure to stent (keep open) your airway.  However, it also feels as if you're drowning in air since it's difficult to exhale against a column of air (one potential solution is BiPAP).  And that's if you can tolerate the mask or nasal pillows (work closely w/your sleep medicine physician).  Don't forget to ask for humidified air if you wake up w/cotton mouth.

Of course there are other options such as pharyngoplasty or dental appliances or in the most recalcitrant cases, jaw advancement.  But I thought I'd mention a nice review just published in JACC looking at how sleep apnea impacts heart failure so hopefully you can use this bit of information to improve your adherence.