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To the Editor: The data of Narkiewicz et al1 expand our understanding of the importance of the imbalance between enhanced central versus peripheral chemoreflex sensitivity in the pathophysiology of congestive heart failure. The authors comment on the links between central cardiovascular and respiratory control, but despite this, patients in this study were not assessed for sleep apnea, which may have confounded their study conclusions.It is known that ≈50% of patients with stable congestive heart failure have associated sleep-disordered breathing, predominantly central sleep apnea (CSA), whereas a minority have obstructive sleep apnea (OSA). We have previously …

Abnormal Breathing During Sleep and Increased Central Chemoreflex Sensitivity in Congestive Heart Failure