The Role of Sleep Apnea in the Acute Exacerbation of Heart Failure

Exclusion Criteria

• •Patients who are already diagnosed with OSA
• •Patients with Central Sleep Apnea
• •Patients with diastolic only heart failure
• •Cardiogenic shock and hemodynamic instability with MAP less than 55 mmHg off vasopressors, or concurrently on vasopressor treatment, left ventricular assist devices, or intra-aortic Balloon Pump. Inotropic agents will not constitute an exclusion criterion. Patients will be eligible once off vasopressors.
• •Acute respiratory failure or insufficiency defined by P/F (PaO2/FIO2) ratio less than 250, or FIO2 requirement more than 50%
• •Overt neurological deficit
• •Renal failure requiring renal replacement therapy; Patients will not be excluded if they were undergoing ultra-filtration for volume removal
• •Patients scheduled for procedures that will interfere with post randomization measurement: This includes scheduled coronary bypass surgery, or expected left ventricular assist device placement.
• •Patients who arrived from a long-term care facility or expected to be discharged to one; and patients who have very poor functional outcome precluding ability to use the CPAP device independently.
• •Patients on long term or "bridging" inotropic infusion, or short life expectancy due to concomitant illness