Insuffisance cardiaque et troubles respiratoires du sommeil

Sleep disordered breathing (SDB) are highly present in heart failure (HF) patients, both systolic and with preserved ejection fraction, from 60 to 70%. Screening for SDB is justified; taking into account that sleepiness is usually absent. SDB in HF patients take several forms: obstructive, central and mixed, the last two being linked to instability in the respiratory control. Concerning treatment, apart from optimizing HF treatment per se, one can consider positive airway pressure (PAP), either a fixed mode for obstructive SDB, or servo-adapted modes for mixed and central SDB. Whatever the mode, treatment should begin in hospital. Despite it strains, PAP should be considered in HF patients given its positive impact on fatigue, quality of life or ejection fraction. Regarding morbimortality, large randomized trial studies are under way.