This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Sin, D. D. Articles by Bradley, T. D. Search for Related Content PubMed PubMed Citation Articles by Sin, D. D. Articles by Bradley, T. D. Pubmed/NCBI databases Medline Plus Health Information Heart Failure Related Collections Congestive Other Treatment Other diagnostic testing

(Circulation. 2000;102:61.)
© 2000 American Heart Association, Inc.

Clinical Investigation and Reports

Effects of Continuous Positive Airway Pressure on Cardiovascular Outcomes in Heart Failure Patients With and Without Cheyne-Stokes Respiration

Don D. Sin, MD, MPH; Alexander G. Logan, MD; Fabia S. Fitzgerald, RN; Peter P. Liu, MD; T. Douglas Bradley, MD

From the Sleep Research Laboratory of the Toronto Rehabilitation Institute (D.D.S., F.S.F., T.D.B.) and the Departments of Medicine at the Toronto General Hospital (University Health Network) (D.D.S., F.S.F., P.P.L., T.D.B.) and Mount Sinai Hospital (A.G.L.), University of Toronto, Toronto, Ontario, Canada.

Correspondence to T. Douglas Bradley, MD, ES 12-421, The Toronto General Hospital/University Health Network, 200 Elizabeth St, Toronto, ON M5G 2C4, Canada. E-mail douglas.bradley{at}utoronto.ca

Background—Continuous positive airway pressure (CPAP) improves cardiac function in patients with congestive heart failure (CHF) who also have Cheyne-Stokes respiration and central sleep apnea (CSR-CSA). However, the effects of CPAP in CHF patients without CSR-CSA have not been tested, and the long-term effects of this treatment on clinical cardiovascular outcomes are unknown.

Methods and Results—We conducted a randomized, controlled trial in which 66 patients with CHF (29 with and 37 without CSR-CSA) were randomized to either a group that received CPAP nightly or to a control group. Change in left ventricular ejection fraction (LVEF) from baseline to 3 months and the combined mortality-cardiac transplantation rate over the median 2.2-year follow-up period were compared between the CPAP-treated and control groups. For the entire group of patients, CPAP had no significant effect on LVEF, but it was associated with a 60% relative risk reduction (95% confidence interval, 2% to 64%) in mortality–cardiac transplantation rate in patients who complied with CPAP therapy. Stratified analysis of patients with and without CSR-CSA revealed that those with CSR-CSA experienced both a significant improvement in LVEF at 3 months and a relative risk reduction of 81% (95% confidence interval, 26% to 95%) in the mortality–cardiac transplantation rate of those who used CPAP. CPAP had no significant effect on either of these outcomes in patients without CSR-CSA.

Conclusions—CPAP improves cardiac function in CHF patients with CSR-CSA but not in those without it. Although not definitive, our findings also suggest that CPAP can reduce the combined mortality–cardiac transplantation rate in those CHF patients with CSR-CSA who comply with therapy.

Key Words: heart assist devices • sleep apnea, central • clinical trials

This article has been cited by other articles:

				N. Takasugi, K. Nishigaki, T. Kubota, K. Tsuchiya, K. Natsuyama, M. Takasugi, T. Nawa, S. Ojio, T. Aoyama, M. Kawasaki, et al. Sleep apnoea induces cardiac electrical instability assessed by T-wave alternans in patients with congestive heart failure Eur J Heart Fail, November 1, 2009; 11(11): 1063 - 1070. [Abstract] [Full Text] [PDF]

				J. D. Gottlieb, A. R. Schwartz, J. Marshall, P. Ouyang, L. Kern, V. Shetty, M. Trois, N. M. Punjabi, C. Brown, S. S. Najjar, et al. Hypoxia, not the frequency of sleep apnea, induces acute hemodynamic stress in patients with chronic heart failure. J. Am. Coll. Cardiol., October 27, 2009; 54(18): 1706 - 1712. [Abstract] [Full Text] [PDF]

				Y. Mebrate, K. Willson, C. H. Manisty, R. Baruah, J. Mayet, A. D. Hughes, K. H. Parker, and D. P. Francis Dynamic CO2 therapy in periodic breathing: a modeling study to determine optimal timing and dosage regimes J Appl Physiol, September 1, 2009; 107(3): 696 - 706. [Abstract] [Full Text] [PDF]

				J S Floras Should sleep apnoea be a specific target of therapy in chronic heart failure? Heart, July 1, 2009; 95(13): 1041 - 1046. [Abstract] [Full Text] [PDF]

				D Yumino, H Wang, J S Floras, G E Newton, S Mak, P Ruttanaumpawan, J D Parker, and T D Bradley Relationship between sleep apnoea and mortality in patients with ischaemic heart failure Heart, May 1, 2009; 95(10): 819 - 824. [Abstract] [Full Text] [PDF]

				L. Luthje, B. Renner, R. Kessels, D. Vollmann, T. Raupach, B. Gerritse, S. Tasci, J. O. Schwab, M. Zabel, D. Zenker, et al. Cardiac resynchronization therapy and atrial overdrive pacing for the treatment of central sleep apnoea Eur J Heart Fail, March 1, 2009; 11(3): 273 - 280. [Abstract] [Full Text] [PDF]

				A. Malhotra Central Sleep Apnea: Diagnosis and Treatment ACCP Sleep Med Brd Rev, January 1, 2009; 4(0): 211 - 216. [Full Text] [PDF]

				B. Sredniawa, R. Lenarczyk, O. Kowalski, P. Pruszkowska-Skrzep, J. Kowalczyk, A. Musialik-Lydka, S. Cebula, and Z. Kalarus Sleep apnoea as a predictor of mid- and long-term outcome in patients undergoing cardiac resynchronization therapy Europace, January 1, 2009; 11(1): 106 - 114. [Abstract] [Full Text] [PDF]

				P. Levy, J-L. Pepin, C. Arnaud, R. Tamisier, J-C. Borel, M. Dematteis, D. Godin-Ribuot, and C. Ribuot Intermittent hypoxia and sleep-disordered breathing: current concepts and perspectives Eur. Respir. J., October 1, 2008; 32(4): 1082 - 1095. [Abstract] [Full Text] [PDF]

				V. K. Somers, D. P. White, R. Amin, W. T. Abraham, F. Costa, A. Culebras, S. Daniels, J. S. Floras, C. E. Hunt, L. J. Olson, et al. Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health) Circulation, September 2, 2008; 118(10): 1080 - 1111. [Full Text] [PDF]

				V. K. Somers, D. P. White, R. Amin, W. T. Abraham, F. Costa, A. Culebras, S. Daniels, J. S. Floras, C. E. Hunt, L. J. Olson, et al. Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health) J. Am. Coll. Cardiol., August 19, 2008; 52(8): 686 - 717. [Full Text] [PDF]

				L. K. Brown Filling in the Gaps: The Role of Noninvasive Adaptive Servoventilation for Heart Failure-Related Central Sleep Apnea Chest, July 1, 2008; 134(1): 4 - 7. [Full Text] [PDF]

				M. Arzt, R. Wensel, S. Montalvan, T. Schichtl, S. Schroll, S. Budweiser, F. C. Blumberg, G. A. J. Riegger, and M. Pfeifer Effects of Dynamic Bilevel Positive Airway Pressure Support on Central Sleep Apnea in Men With Heart Failure Chest, July 1, 2008; 134(1): 61 - 66. [Abstract] [Full Text] [PDF]

				A. Garcia-Touchard, V. K. Somers, L. J. Olson, and S. M. Caples Central Sleep Apnea: Implications for Congestive Heart Failure Chest, June 1, 2008; 133(6): 1495 - 1504. [Abstract] [Full Text] [PDF]

				O. Oldenburg, A. Schmidt, B. Lamp, T. Bitter, B. G. Muntean, C. Langer, and D. Horstkotte Adaptive servoventilation improves cardiac function in patients with chronic heart failure and Cheyne-Stokes respiration Eur J Heart Fail, June 1, 2008; 10(6): 581 - 586. [Abstract] [Full Text] [PDF]

				D. Yumino and T. D. Bradley Central Sleep Apnea and Cheyne-Stokes Respiration Proceedings of the ATS, February 15, 2008; 5(2): 226 - 236. [Abstract] [Full Text] [PDF]

				J Amit Benjamin and K E Lewis Sleep-disordered breathing and cardiovascular disease Postgrad. Med. J., January 1, 2008; 84(987): 15 - 22. [Abstract] [Full Text] [PDF]

				D. Pevernagie, J. P. Janssens, W. De Backer, M. Elliott, J. Pepperell, and S. Andreas Ventilatory support and pharmacological treatment of patients with central apnoea or hypoventilation during sleep Eur. Respir. Rev., December 1, 2007; 16(106): 115 - 124. [Abstract] [Full Text] [PDF]

				S. Javaheri Treatment of obstructive and central sleep apnoea in heart failure: practical options Eur. Respir. Rev., December 1, 2007; 16(106): 183 - 188. [Abstract] [Full Text] [PDF]

				T. Brack, I. Thuer, C. F. Clarenbach, O. Senn, G. Noll, E. W. Russi, and K. E. Bloch Daytime Cheyne-Stokes Respiration in Ambulatory Patients With Severe Congestive Heart Failure Is Associated With Increased Mortality Chest, November 1, 2007; 132(5): 1463 - 1471. [Abstract] [Full Text] [PDF]

				G. Parati, C. Lombardi, and K. Narkiewicz Sleep apnea: epidemiology, pathophysiology, and relation to cardiovascular risk Am J Physiol Regulatory Integrative Comp Physiol, October 1, 2007; 293(4): R1671 - R1683. [Abstract] [Full Text] [PDF]

				M. T. La Rovere, G. D. Pinna, R. Maestri, E. Robbi, A. Mortara, F. Fanfulla, O. Febo, and P. Sleight Clinical relevance of short-term day-time breathing disorders in chronic heart failure patients Eur J Heart Fail, September 1, 2007; 9(9): 949 - 954. [Abstract] [Full Text] [PDF]

				O. Oldenburg, L. Faber, J. Vogt, A. Dorszewski, F. Szabados, D. Horstkotte, and B. Lamp Influence of cardiac resynchronisation therapy on different types of sleep disordered breathing Eur J Heart Fail, August 1, 2007; 9(8): 820 - 826. [Abstract] [Full Text] [PDF]

				T. Dernaika, M. Tawk, S. Nazir, W. Younis, and G. T. Kinasewitz The Significance and Outcome of Continuous Positive Airway Pressure-Related Central Sleep Apnea During Split-Night Sleep Studies Chest, July 1, 2007; 132(1): 81 - 87. [Abstract] [Full Text] [PDF]

				L. J. Olson and V. K. Somers Treating Central Sleep Apnea in Heart Failure: Outcomes Revisited Circulation, June 26, 2007; 115(25): 3140 - 3142. [Full Text] [PDF]

				M. Arzt, J. S. Floras, A. G. Logan, R. J. Kimoff, F. Series, D. Morrison, K. Ferguson, I. Belenkie, M. Pfeifer, J. Fleetham, et al. Suppression of Central Sleep Apnea by Continuous Positive Airway Pressure and Transplant-Free Survival in Heart Failure: A Post Hoc Analysis of the Canadian Continuous Positive Airway Pressure for Patients With Central Sleep Apnea and Heart Failure Trial (CANPAP) Circulation, June 26, 2007; 115(25): 3173 - 3180. [Abstract] [Full Text] [PDF]

				A. Noda, H. Izawa, H. Asano, S. Nakata, A. Hirashiki, Y. Murase, S. Iino, K. Nagata, T. Murohara, Y. Koike, et al. Beneficial Effect of Bilevel Positive Airway Pressure on Left Ventricular Function in Ambulatory Patients With Idiopathic Dilated Cardiomyopathy and Central Sleep Apnea-Hypopnea: A Preliminary Study Chest, June 1, 2007; 131(6): 1694 - 1701. [Abstract] [Full Text] [PDF]

				C. C Lang and D. M Mancini Non-cardiac comorbidities in chronic heart failure Heart, June 1, 2007; 93(6): 665 - 671. [Abstract] [Full Text] [PDF]

				H. Wang, J. D. Parker, G. E. Newton, J. S. Floras, S. Mak, K.-L. Chiu, P. Ruttanaumpawan, G. Tomlinson, and T. D. Bradley Influence of Obstructive Sleep Apnea on Mortality in Patients With Heart Failure J. Am. Coll. Cardiol., April 17, 2007; 49(15): 1625 - 1631. [Abstract] [Full Text] [PDF]

				A. Vazir, P.C. Hastings, M. Dayer, H.F. McIntyre, M.Y. Henein, P.A. Poole-Wilson, M.R. Cowie, M.J. Morrell, and A.K. Simonds A high prevalence of sleep disordered breathing in men with mild symptomatic chronic heart failure due to left ventricular systolic dysfunction Eur J Heart Fail, March 1, 2007; 9(3): 243 - 250. [Abstract] [Full Text] [PDF]

				C. H. Manisty, K. Willson, R. Wensel, Z. I. Whinnett, J. E. Davies, W. L. G. Oldfield, J. Mayet, and D. P. Francis Development of respiratory control instability in heart failure: a novel approach to dissect the pathophysiological mechanisms J. Physiol., November 15, 2006; 577(1): 387 - 401. [Abstract] [Full Text] [PDF]

				C. A. Fiack, H. W. Farber, M. A. Arias, A. Alonso-Fernandez, F. Garcia-Rio, K. M. Kessler, A. Ahmed, J. L. Fleg, M. Gheorghiade, T. E. Owan, et al. Heart failure with preserved ejection fraction. N. Engl. J. Med., October 26, 2006; 355(17): 1828 - 1828. [Full Text] [PDF]

				V. L. Wittmer, G. M. S. Simoes, L. C. M. Sogame, and E. C. Vasquez Effects of continuous positive airway pressure on pulmonary function and exercise tolerance in patients with congestive heart failure. Chest, July 1, 2006; 130(1): 157 - 163. [Abstract] [Full Text] [PDF]

				M. Arzt and T. D. Bradley Treatment of Sleep Apnea in Heart Failure Am. J. Respir. Crit. Care Med., June 15, 2006; 173(12): 1300 - 1308. [Abstract] [Full Text] [PDF]

				S. Ferreira, J. Winck, P. Bettencourt, and F. Rocha-Goncalves Heart failure and sleep apnoea: To sleep perchance to dream Eur J Heart Fail, May 1, 2006; 8(3): 227 - 236. [Abstract] [Full Text] [PDF]

				A. Vazir, M. Dayer, P. C. Hastings, H. F. McIntyre, M. Y. Henein, P. A. Poole-Wilson, M. R. Cowie, M. J. Morrell, and A. K. Simonds Can heart rate variation rule out sleep-disordered breathing in heart failure? Eur. Respir. J., March 1, 2006; 27(3): 571 - 577. [Abstract] [Full Text] [PDF]

				C Philippe, M Stoica-Herman, X Drouot, B Raffestin, P Escourrou, L Hittinger, P-L Michel, S Rouault, and M-P d'Ortho Compliance with and effectiveness of adaptive servoventilation versus continuous positive airway pressure in the treatment of Cheyne-Stokes respiration in heart failure over a six month period Heart, March 1, 2006; 92(3): 337 - 342. [Abstract] [Full Text] [PDF]

				J. P. Ribeiro Periodic Breathing in Heart Failure: Bridging the Gap Between the Sleep Laboratory and the Exercise Laboratory Circulation, January 3, 2006; 113(1): 9 - 10. [Full Text] [PDF]

				U. Corra, M. Pistono, A. Mezzani, A. Braghiroli, A. Giordano, P. Lanfranchi, E. Bosimini, M. Gnemmi, and P. Giannuzzi Sleep and Exertional Periodic Breathing in Chronic Heart Failure: Prognostic Importance and Interdependence Circulation, January 3, 2006; 113(1): 44 - 50. [Abstract] [Full Text] [PDF]

				A. I. Pack Advances in Sleep-disordered Breathing Am. J. Respir. Crit. Care Med., January 1, 2006; 173(1): 7 - 15. [Abstract] [Full Text] [PDF]

				S. M. Caples, R. Wolk, and V. K. Somers Influence of cardiac function and failure on sleep-disordered breathing: evidence for a causative role J Appl Physiol, December 1, 2005; 99(6): 2433 - 2439. [Abstract] [Full Text] [PDF]

				J. Spaak, Z. J. Egri, T. Kubo, E. Yu, S.-I. Ando, Y. Kaneko, K. Usui, T. D. Bradley, and J. S. Floras Muscle Sympathetic Nerve Activity During Wakefulness in Heart Failure Patients With and Without Sleep Apnea Hypertension, December 1, 2005; 46(6): 1327 - 1332. [Abstract] [Full Text] [PDF]

				T. D. Bradley, A. G. Logan, R. J. Kimoff, F. Series, D. Morrison, K. Ferguson, I. Belenkie, M. Pfeifer, J. Fleetham, P. Hanly, et al. Continuous Positive Airway Pressure for Central Sleep Apnea and Heart Failure. N. Engl. J. Med., November 10, 2005; 353(19): 2025 - 2033. [Abstract] [Full Text] [PDF]

				V. K. Somers Sleep -- A New Cardiovascular Frontier N. Engl. J. Med., November 10, 2005; 353(19): 2070 - 2073. [Full Text] [PDF]

				K. Ferrier, A. Campbell, B. Yee, M. Richards, T. O'Meeghan, M. Weatherall, and A. Neill Sleep-Disordered Breathing Occurs Frequently in Stable Outpatients With Congestive Heart Failure Chest, October 1, 2005; 128(4): 2116 - 2122. [Abstract] [Full Text] [PDF]

				K. G. Johnson and D. C. Johnson Bilevel Positive Airway Pressure Worsens Central Apneas During Sleep Chest, October 1, 2005; 128(4): 2141 - 2150. [Abstract] [Full Text] [PDF]

				L J Cormican and A Williams Sleep disordered breathing and its treatment in congestive heart failure Heart, October 1, 2005; 91(10): 1265 - 1270. [Abstract] [Full Text] [PDF]

				L. S. Doherty, J. L. Kiely, V. Swan, and W. T. McNicholas Long-term Effects of Nasal Continuous Positive Airway Pressure Therapy on Cardiovascular Outcomes in Sleep Apnea Syndrome Chest, June 1, 2005; 127(6): 2076 - 2084. [Abstract] [Full Text] [PDF]

				C. Sahlin, E. Svanborg, H. Stenlund, and K. A. Franklin Cheyne-Stokes respiration and supine dependency Eur. Respir. J., May 1, 2005; 25(5): 829 - 833. [Abstract] [Full Text] [PDF]

				F. Series, R. J. Kimoff, D. Morrison, M. H. Leblanc, M. Smilovitch, J. Howlett, A. G. Logan, J. S. Floras, and T. D. Bradley Prospective Evaluation of Nocturnal Oximetry for Detection of Sleep-Related Breathing Disturbances in Patients With Chronic Heart Failure Chest, May 1, 2005; 127(5): 1507 - 1514. [Abstract] [Full Text] [PDF]

				D. Kaye and M. Esler Sympathetic neuronal regulation of the heart in aging and heart failure Cardiovasc Res, May 1, 2005; 66(2): 256 - 264. [Abstract] [Full Text] [PDF]

				M. Arzt, M. Schulz, R. Wensel, S. Montalvan, F. C. Blumberg, G. A. J. Riegger, and M. Pfeifer Nocturnal Continuous Positive Airway Pressure Improves Ventilatory Efficiency During Exercise in Patients With Chronic Heart Failure Chest, March 1, 2005; 127(3): 794 - 802. [Abstract] [Full Text] [PDF]

				M. A. Skinner, M. S. Choudhury, S. D.R. Homan, J. O. Cowan, G. T. Wilkins, and D. R. Taylor Accuracy of Monitoring for Sleep-Related Breathing Disorders in the Coronary Care Unit Chest, January 1, 2005; 127(1): 66 - 71. [Abstract] [Full Text] [PDF]

				P Gordon and M H Sanders Sleep {middle dot} 7: Positive airway pressure therapy for obstructive sleep apnoea/hypopnoea syndrome Thorax, January 1, 2005; 60(1): 68 - 75. [Abstract] [Full Text] [PDF]

				P. Bordier, S. Garrigue, S. Reuter, P. Bordachar, and J. Clementy Death During Polysomnography of a Patient With Cheyne-Stokes Respiration, Respiratory Acidosis, and Chronic Heart Failure Chest, November 1, 2004; 126(5): 1698 - 1700. [Abstract] [Full Text] [PDF]

				A. Mortara, G. D. Pinna, P. Johnson, H. Dargie, M. T. La Rovere, P. Ponikowski, L. Tavazzi, P. Sleight, and on behalf of HHH Investigators A multi-country randomised trial of the role of a new telemonitoring system in CHF: the HHH study (Home or Hospital in Heart Failure). Rational, study design and protocol Eur. Heart J. Suppl., November 1, 2004; 6(suppl_F): F99 - F102. [Abstract] [Full Text] [PDF]

				C. Scharf, Y. K. Cho, K. E. Bloch, C. Brunckhorst, F. Duru, K. Balaban, N. Foldvary, L. Liu, R. C. Burgess, R. Candinas, et al. Diagnosis of Sleep-Related Breathing Disorders by Visual Analysis of Transthoracic Impedance Signals in Pacemakers Circulation, October 26, 2004; 110(17): 2562 - 2567. [Abstract] [Full Text] [PDF]

				S. Andreas, H. Reiter, L. Luthje, A. Delekat, R. W. Grunewald, G. Hasenfuss, and V. K. Somers Differential Effects of Theophylline on Sympathetic Excitation, Hemodynamics, and Breathing in Congestive Heart Failure Circulation, October 12, 2004; 110(15): 2157 - 2162. [Abstract] [Full Text] [PDF]

				B. Pieske Reverse remodeling in heart failure - fact or fiction? Eur. Heart J. Suppl., August 1, 2004; 6(suppl_D): D66 - D78. [Abstract] [Full Text] [PDF]

				J. M. Parish and V. K. Somers Obstructive Sleep Apnea and Cardiovascular Disease Mayo Clin. Proc., August 1, 2004; 79(8): 1036 - 1046. [Abstract] [PDF]

				A.-M. Sinha, E. C. Skobel, O.-A. Breithardt, C. Norra, K. U. Markus, C. Breuer, P. Hanrath, and C. Stellbrink Cardiac resynchronization therapy improves central sleep apnea and Cheyne-Stokes respiration in patients with chronic heart failure J. Am. Coll. Cardiol., July 7, 2004; 44(1): 68 - 71. [Abstract] [Full Text] [PDF]

				A. M. Omran, S. E. Aboubakr, L. S. Aboussouan, L. Pierchala, and M. S. Badr Posthypoxic ventilatory decline during NREM sleep: influence of sleep apnea J Appl Physiol, June 1, 2004; 96(6): 2220 - 2225. [Abstract] [Full Text] [PDF]

				H.F. Becker Bigger numbers needed! Eur. Respir. J., May 1, 2004; 23(5): 659 - 660. [Full Text] [PDF]

				T. Roebuck, P. Solin, D.M. Kaye, P. Bergin, M. Bailey, and M.T. Naughton Increased long-term mortality in heart failure due to sleep apnoea is not yet proven Eur. Respir. J., May 1, 2004; 23(5): 735 - 740. [Abstract] [Full Text] [PDF]

				S. F. Quan and B. J. Gersh Cardiovascular Consequences of Sleep-Disordered Breathing: Past, Present and Future: Report of a Workshop From the National Center on Sleep Disorders Research and the National Heart, Lung, and Blood Institute Circulation, March 2, 2004; 109(8): 951 - 957. [Full Text] [PDF]

				I. Fietze, D. Romberg, M. Glos, S. Endres, H. Theres, C. Witt, and V. K. Somers Effects of positive-pressure ventilation on the spontaneous baroreflex in healthy subjects J Appl Physiol, March 1, 2004; 96(3): 1155 - 1160. [Abstract] [Full Text] [PDF]

				B. K. Gehlbach and E. Geppert The Pulmonary Manifestations of Left Heart Failure Chest, February 1, 2004; 125(2): 669 - 682. [Abstract] [Full Text] [PDF]

				R. Schulz, C. Fegbeutel, H. Olschewski, F. Rose, H.-J. Schafers, and W. Seeger Reversal of Nocturnal Periodic Breathing in Primary Pulmonary Hypertension After Lung Transplantation Chest, January 1, 2004; 125(1): 344 - 347. [Abstract] [Full Text] [PDF]

				J Fleetham Sleep disordered breathing awoken Thorax, January 1, 2004; 59(1): 5 - 6. [Full Text] [PDF]

				D. D. Sin and G. C. W. Man Cheyne-Stokes Respiration: A Consequence of a Broken Heart? Chest, November 1, 2003; 124(5): 1627 - 1628. [Full Text] [PDF]

				J. C. T. Pepperell, N. A. Maskell, D. R. Jones, B. A. Langford-Wiley, N. Crosthwaite, J. R. Stradling, and R. J. O. Davies A Randomized Controlled Trial of Adaptive Ventilation for Cheyne-Stokes Breathing in Heart Failure Am. J. Respir. Crit. Care Med., November 1, 2003; 168(9): 1109 - 1114. [Abstract] [Full Text] [PDF]

				A. S. M. Shamsuzzaman, B. J. Gersh, and V. K. Somers Obstructive Sleep Apnea: Implications for Cardiac and Vascular Disease JAMA, October 8, 2003; 290(14): 1906 - 1914. [Abstract] [Full Text] [PDF]

				S. Ancoli-Israel, E. R. DuHamel, C. Stepnowsky, R. Engler, M. Cohen-Zion, and M. Marler The Relationship Between Congestive Heart Failure, Sleep Apnea, and Mortality in Older Men Chest, October 1, 2003; 124(4): 1400 - 1405. [Abstract] [Full Text] [PDF]

				A. A. Louis, T. Turner, M. Gretton, A. Baksh, and J. G.F. Cleland A systematic review of telemonitoring for the management of heart failure Eur J Heart Fail, October 1, 2003; 5(5): 583 - 590. [Abstract] [Full Text] [PDF]

				R. Wolk, T. Kara, and V. K. Somers Sleep-Disordered Breathing and Cardiovascular Disease Circulation, July 8, 2003; 108(1): 9 - 12. [Full Text] [PDF]

				T. D. Bradley The ups and downs of periodic breathing: Implications for mortality in heart failure J. Am. Coll. Cardiol., June 18, 2003; 41(12): 2182 - 2184. [Full Text] [PDF]

				R. S. T. Leung, J. S. Floras, G. Lorenzi-Filho, F. Rankin, P. Picton, and T. D. Bradley Influence of Cheyne-Stokes Respiration on Cardiovascular Oscillations in Heart Failure Am. J. Respir. Crit. Care Med., June 1, 2003; 167(11): 1534 - 1539. [Abstract] [Full Text] [PDF]

				M. R. Mehra, P. A. Uber, and G. S. Francis Heart failure therapy at a crossroad: are there limits to the neurohormonal model? J. Am. Coll. Cardiol., May 7, 2003; 41(9): 1606 - 1610. [Abstract] [Full Text] [PDF]

				M. Arzt, M. Harth, A. Luchner, F. Muders, S. R. Holmer, F. C. Blumberg, G. A.J. Riegger, and M. Pfeifer Enhanced Ventilatory Response to Exercise in Patients With Chronic Heart Failure and Central Sleep Apnea Circulation, April 22, 2003; 107(15): 1998 - 2003. [Abstract] [Full Text] [PDF]

				A. Malhotra, V. V. Muse, and E. J. Mark Case 12-2003 - An 82-Year-Old Man with Dyspnea and Pulmonary Abnormalities N. Engl. J. Med., April 17, 2003; 348(16): 1574 - 1585. [Full Text] [PDF]

				T. D. Bradley and J. S. Floras Sleep Apnea and Heart Failure: Part II: Central Sleep Apnea Circulation, April 8, 2003; 107(13): 1822 - 1826. [Full Text] [PDF]

				T. D. Bradley and J. S. Floras Sleep Apnea and Heart Failure: Part I: Obstructive Sleep Apnea Circulation, April 1, 2003; 107(12): 1671 - 1678. [Full Text] [PDF]

				Y. Kaneko, J. S. Floras, K. Usui, J. Plante, R. Tkacova, T. Kubo, S.-i. Ando, and T. D. Bradley Cardiovascular Effects of Continuous Positive Airway Pressure in Patients with Heart Failure and Obstructive Sleep Apnea N. Engl. J. Med., March 27, 2003; 348(13): 1233 - 1241. [Abstract] [Full Text] [PDF]

				M. R. Littner and S. Han Cheyne-Stokes Respiration and Congestive Heart Failure: Are Oxygen Stores the Critical Factor? Chest, January 1, 2003; 123(1): 7 - 9. [Full Text] [PDF]

				C. Chan, J. S. Floras, J. A. Miller, and A. Pierratos Improvement in ejection fraction by nocturnal haemodialysis in end-stage renal failure patients with coexisting heart failure Nephrol. Dial. Transplant., August 1, 2002; 17(8): 1518 - 1521. [Abstract] [Full Text] [PDF]

				T Kohnlein, T Welte, L B Tan, and M W Elliott Central sleep apnoea syndrome in patients with chronic heart disease: a critical review of the current literature Thorax, June 1, 2002; 57(6): 547 - 554. [Abstract] [Full Text] [PDF]

				J. W. H. Fung, T. S. T. Li, D. K. L. Choy, G. W. K. Yip, F. W. S. Ko, J. E. Sanderson, and D. S. C. Hui Severe Obstructive Sleep Apnea Is Associated With Left Ventricular Diastolic Dysfunction Chest, February 1, 2002; 121(2): 422 - 429. [Abstract] [Full Text] [PDF]

				G. Lorenzi-Filho, E.R. Azevedo, J.D. Parker, and T.D. Bradley Relationship of carbon dioxide tension in arterial blood to pulmonary wedge pressure in heart failure Eur. Respir. J., January 1, 2002; 19(1): 37 - 40. [Abstract] [Full Text] [PDF]

				R. S. T. LEUNG and T. DOUGLAS BRADLEY Sleep Apnea and Cardiovascular Disease Am. J. Respir. Crit. Care Med., December 15, 2001; 164(12): 2147 - 2165. [Full Text] [PDF]

				A. T. Yan, T. D. Bradley, and P. P. Liu The Role of Continuous Positive Airway Pressure in the Treatment of Congestive Heart Failure Chest, November 1, 2001; 120(5): 1675 - 1685. [Abstract] [Full Text] [PDF]

				R. M. Mehta, M. L. Groth, T. D. Bradley, F. S. Fitzgerald, D. D. Sin, P. P. Liu, and A. G. Logan Continuous Positive Airway Pressure in Patients With Congestive Heart Failure and Cheyne-Stokes Respiration With Central Sleep Apnea Response Circulation, June 12, 2001; 103 (23): e121 - e121. [Full Text] [PDF]

				D. M. Kaye, D. Mansfield, A. Aggarwal, M. T. Naughton, and M. D. Esler Acute Effects of Continuous Positive Airway Pressure on Cardiac Sympathetic Tone in Congestive Heart Failure Circulation, May 15, 2001; 103(19): 2336 - 2338. [Abstract] [Full Text] [PDF]

				R. Tkacova, M. Niroumand, G. Lorenzi-Filho, and T. D. Bradley Overnight Shift From Obstructive to Central Apneas in Patients With Heart Failure : Role of PCO2 and Circulatory Delay Circulation, January 16, 2001; 103(2): 238 - 243. [Abstract] [Full Text] [PDF]

				C. F. Notarius and J. S. Floras Limitations of the use of spectral analysis of heart rate variability for the estimation of cardiac sympathetic activity in heart failure Europace, January 1, 2001; 3(1): 29 - 38. [Abstract] [PDF]