Navigating the 'Double Trouble' of Heart Failure and Sleep Apnoea

Living with chronic heart failure is a formidable challenge, but adding obstructive sleep apnoea to the mix creates a compounding burden. A recent systematic review involving 14 studies and 2,048 patients has highlighted exactly how this combination impairs quality of life, physical capacity, and cardiac function.

The review examined various interventions to manage sleep-disordered breathing. Continuous positive airway pressure (CPAP)—a standard treatment that keeps airways open using mild air pressure—emerged as a beneficial tool. It was found to improve sleep quality, exercise performance, and left ventricular function, which refers to the heart's ability to pump oxygenated blood to the body.

However, the data issued a stark warning regarding adaptive servo-ventilation (ASV), a more complex, computer-controlled ventilation method. While ASV successfully reduced respiratory events, it was associated with higher mortality rates in patients with reduced heart function, proving that high-tech solutions are not always safer.

Interestingly, while nocturnal oxygen therapy improved specific respiratory metrics, it failed to make patients feel better in terms of their overall quality of life. In contrast, structured exercise programmes demonstrated clear benefits for patients' functional status. The findings underscore that a 'one-size-fits-all' approach is dangerous; instead, personalised care plans are essential to safely improve life for these patients.