Seek and treat obstructive sleep apnea in heart failure.

bstructive sleep apnea (OSA) is a highly prevalent disorer. It affects 9% to 25% of the North American population 1–4). Intermittent cessation of breathing during sleep aused by occlusion of the upper airway followed by arousals rom sleep defines OSA. The prevalence of OSA is even reater among patients with chronic heart failure (CHF). pproximately one-third to one-half of the 5 million mericans with CHF suffers from concomitant OSA, specially those with severe CHF (5–7). Notwithstanding he sheer number of patients with OSA and obesity as a ommon risk factor, repetitive episodes of hypoxia/ eoxygenation, augmented intrathoracic pressure swings, nd arousals from sleep promote arterial stiffness, hypertenion, and increased sympathetic activity that account for the requent coexistence of OSA and CHF (8–10). Patients ith OSA are 2.2 times more likely to develop CHF than atients without OSA, and patients with CHF who develop SA are thought to have a worse prognosis than patients ith CHF alone (11).