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Diuretics Improve Sleep Apnea in Patients with Heart Failure

Pharyngeal edema may contribute to sleep-disordered breathing

WEDNESDAY, Aug. 15 (HealthDay News) -- Patients with obstructive sleep apnea and diastolic heart failure who are treated with diuretics have improvements in disordered breathing, increases in oropharyngeal junction area and improved airflow rates, according to a report published in the August issue of Chest. These findings suggest that upper airway edema contributes to sleep-disordered breathing.

Caterina Bucca, M.D., of the University of Turin in Italy, and colleagues treated 15 patients with severe obstructive sleep apnea, hypertension and diastolic heart failure with intravenous furosemide and spironolactone for three days to determine if intensive diuresis increased pharyngeal caliber and improved sleep-disordered breathing. Polysomnography was performed to determine apnea-hypopnea index, acoustic pharyngometry was used to measure oropharyngeal junction area and lung function tests were undertaken to determine airflow rates.

Treatment with diuretics resulted in a significant decrease in body weight, blood pressure, apnea-hypopnea index, and an improvement in oropharyngeal junction area, forced midinspiratory flow and forced midexpiratory flow percentage. Weight loss was significantly associated with a decrease in apnea-hypopnea index and improvements in airflow measures.

"Our findings suggest that in obese patients with severe obstructive sleep apnea and diastolic heart failure, pharyngeal edema contributes to sleep-disordered breathing and might account for the frequent occurrence of obstructive sleep apnea in patients with heart disease," the authors conclude.

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