Нарушения дыхания во время сна у пациентов с застойной сердечной недостаточностью

Nighttime cardiorespiratory monitoring was performed in 30 congestive heart failure ( CHF ) patients resulting from ischaemic heart disease, systemic arterial hypertension and dilating cardiomiopathy. The results were compared with those of obstructive sleep apnoea and hypopnoea syndrome ( OSAHS ) patients with no CHF signs. Sleep disorders were found in all the patients tested. Mild to moderate OSAHS prevailed. It was determined that inspiratory and expiratory time and total tidal time were significantly reduced ( p <0.05) and breathing frequency increased in the CHF patients compared to a control group. The CHF patients demonstrated an increase of a minute ventilation, a tidal volume and the mean inspiratory flow while sleep disorders became more severe. These resulted from hypoxic stimulation of the encephalic breathing center. Moreover, changes of a functional residual capacity and intraalveolar volume were found at a positive pressure end-expiration. The changes revealed can cause fatigue and weakness of respiratory muscles and disturb an intracardiac haemodynamics. So, we propose that CFH patients need CPAP -therapy during sleep.