Central Sleep Apnea and Heart Failure

To the Editor: The article by Javaheri (Sept. 23 issue) 1 expands our understanding of the key role of enhanced central chemoreflex sensitivity, including increased ventilatory responsiveness to hyperoxic hypercapnia while awake, in the pathophysiology of central sleep apnea in patients with congestive heart failure. However, it remains to be determined whether this abnormality is a predisposing factor for, or a consequence of, the development of congestive heart failure. We reported our observation of increased ventilatory responses in patients with heart failure and central sleep apnea in 1993, 2 and we subsequently reported that patients with obstructive apnea and heart failure had . . .