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Two main types of apnoea occur: one is obstructive which, through recurring episodes of snoring, hypoxaemia, large negative intra\u2010thoracic pressures and arousals from sleep leading to downstream inflammatory and autonomic nervous system changes, is thought to be a causative factor to the development of systemic hypertension and <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>. The other type of apnoea, Cheyne\u2013Stokes respiration with central sleep apnoea (<jats:styled-content style=\"fixed-case\">CSR\u2010CSA<\/jats:styled-content>), is characterized by an oscillatory pattern of ventilation with a prevailing hyperventilation\u2010induced hypocapnia, often in the absence of significant hypoxaemia and snoring, and is thought to be a consequence of advanced <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\u2010related low cardiac output, high sympathetic nervous system activation and pulmonary congestion. <jats:styled-content style=\"fixed-case\">CSR\u2010CSA<\/jats:styled-content> may be a compensatory response to advanced <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>. Rostral fluid shift during sleep may play an important role in the pathogenesis of both obstructive sleep apnoea (<jats:styled-content style=\"fixed-case\">OSA<\/jats:styled-content>) and <jats:styled-content style=\"fixed-case\">CSA<\/jats:styled-content>. Studies of positive airway pressure (<jats:styled-content style=\"fixed-case\">PAP<\/jats:styled-content>) treatment of <jats:styled-content style=\"fixed-case\">OSA<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">CSA<\/jats:styled-content> in <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content> have shown short\u2010term improvements in cardiac and autonomic function; however, there is no evidence of improved survival. Loop gain may provide useful marker of continuous <jats:styled-content style=\"fixed-case\">PAP<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">CPAP<\/jats:styled-content>) responsiveness in patients with central apnoea. A greater understanding of the pathophysiology of the interaction between obstructive and central apnoea and the various types of <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>, and the mechanisms of therapies, such as <jats:styled-content style=\"fixed-case\">PAP<\/jats:styled-content>, is required to develop new strategies to overcome the disabling symptoms, and perhaps improve the mortality, that accompany <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content> with sleep apnoea.<\/jats:p>","DOI":"10.1111\/resp.12964","type":"journal-article","created":{"date-parts":[[2016,12,21]],"date-time":"2016-12-21T00:12:43Z","timestamp":1482279163000},"page":"217-229","source":"Crossref","is-referenced-by-count":48,"title":["Sleep apnoea in heart failure: To treat or not to treat?"],"prefix":"10.1111","volume":"22","author":[{"given":"Matthew T.","family":"Naughton","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine Alfred Hospital  Melbourne Victoria Australia"},{"name":"Central Clinical School Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirk","family":"Kee","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Alfred Hospital  Melbourne Victoria Australia"},{"name":"Central Clinical School Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,12,20]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.11.053"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra021498"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.584102"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.812172"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp0909392"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejheart.2006.08.003"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2015.09.014"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws342"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(15)00043-0"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201503-0536OC"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.163.1.2001008"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.901801"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.103.2.238"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/30.11.1509"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00066709"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.12.007"},{"key":"e_1_2_9_18_1","unstructured":"HuntSA BakerDW ChinMH CinquegraniMP FeldmanAM FrancisGS GaniatsTG GoldsteinS GregoratosG JessupMLet al.;American College of Cardiology\/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1995 Guidelines for the Evaluation and Management of Heart Failure);International Society for Heart and Lung Transplantation;Heart Failure Society of America. 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