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Central sleep apnoea in heart failure — SCE Respiratory MCQ

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HardSleep MedicineCentral sleep apnoea in heart failureSCE Respiratory

A 67-year-old man with heart failure with reduced ejection fraction has witnessed apnoeas and daytime fatigue. Polysomnography shows central apnoea index 32/hour with Cheyne-Stokes respiration. LVEF is 28%. What is the most appropriate management?

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Correct answer: B — Optimise heart failure therapy and seek specialist sleep-cardiology advice

Central sleep apnoea with Cheyne-Stokes respiration in severe HFrEF should prompt optimisation of heart failure therapy and specialist assessment; adaptive servo-ventilation is not routine in reduced LVEF because of safety concerns. Mandibular devices and tonsillectomy target obstructive upper-airway disease. Oxygen alone is not a substitute for cardiac optimisation and specialist review.

Reference: NICE NG202 OSAHS/OHS; SERVE-HF evidence; ESC heart failure guidance