Assessment of the Efficacy of Interventions for the Treatment of Sleep Respiratory Disorder in Chronic Heart Failure Patients: A Systematic Review

One of the most important problems of heart failure (HF) patients is sleep disturbance. In HF patients with obstructive and central sleep apnea, hypoxia, hypercapnia and over-excitation of the sympathetic system are observed. As a result, negative intrathoracic pressure and left ventricular afterload increase. Treatment of sleep respiratory disorders in chronic HF patients is important for the prognosis of the disease. Therefore, in this systematic review, we aimed to evaluate the efficacy of interventions used for the treatment of sleep respiratory disorder in chronic HF patients. Cochrane Library, Scopus, Springer Link, Science Direct, Clinical Key, PubMed, Turkey Citation Index and EBSCO databases were searched for studies between June 2017-August 2018. When all studies were examined, out of 2.691.006 studies published between 2007-2017, 16 randomized controlled trials that met inclusion criteria were included in the study. In these studies, treatment interventions for treatment groups with sleep respiratory disorder included continuous positive airway pressure (CPAP), bi-level positive airway pressure, adaptive servo-ventilation (ASV), atrial overdrive pacing, home oxygen therapy, slow breathing exercise device and structured physical exercise. When the study results are examined, CPAP treatment improved daytime sleepiness and left ventricular ejection fraction (LVEF) but did not provide significant improvement on quality of life, and that ASV treatment reduced apneahypopnea index, provided improvement in LVEF and cardiac function, and reduced ventricular ejection fraction. However, further research is needed to fully demonstrate the efficacy of interventions for the treatment of sleep respiratory disorder in chronic HF patients.