Heart function can be significantly improved in patients with congestive heart failure and obstructive sleep apnea by treating this sleep disorder with a simple easy-to-use, portable device, according to a first-ever randomized clinical trial of patients with heart failure conducted at Toronto General Hospital (TGH), University Health Network (UHN), Mount Sinai Hospital and the Toronto Rehabilitation Institute.
The study was funded in part by unrestricted Research Fellowships from Respironics Inc, the leader in innovative products and therapies for treating Obstructive Sleep Apnea (OSA) and other respiratory diseases in both home and clinical settings.
It is estimated that about one third of all patients with heart failure have obstructive sleep apnea.
The study tested 24 patients with heart failure who also had obstructive sleep apnea. All patients were on medication for their heart failure. Twelve (12) participants were then randomly assigned to receive medical therapy alone (medication), and another 12 were randomly assigned to receive treatment (medication) for their heart failure, as well as treatment for their obstructive sleep apnea using a device called continuous positive airway pressure (CPAP). Patients were tested before and after one month of either receiving medication alone or both the CPAP treatment and medication.
Obstructive sleep apnea is a disorder in which involuntary breath holding during sleep occurs at least 15 to 20 times an hour at night. This happens when the muscles holding the throat open relax during sleep, narrowing and obstructing the throat. This then prevents the flow of air into the lungs, causing suffocation and stress to the failing heart. The commonest risk factor for obstructive sleep apnea is obesity.
CPAP, which is used to treat sleep apnea, consists of a small mask that is placed over the nose during sleep and is connected by tubing to an air pressure pump that is plugged into a wall socket. Air pressure in the tubing is transmitted to the mask and then flows continuously through the nose into the throat, propping it open and preventing it from collapsing during the night. This eliminates obstructive sleep apnea.
Congestive heart failure is a disease of the heart muscle, which has left it so weak that it cannot pump sufficient blood to meet the demands of the rest of the body for blood and oxygen. The commonest cause of heart failure is a heart attack. About 1% of the adult population in North America has congestive heart failure, and it is the leading cause of hospital admission for individuals above the age of 65.