Madison Rosen, Lee R Goldberg
The interplay between sleep-disordered breathing (SDB) and cardiovascular disease, particularly arrhythmias and heart failure, is complex and bidirectional. This article examines the impact of SDB in cardiovascular disease and heart failure. It is proposed that teams interested in improving SDB diagnosis and management take ACTION (assess for risk factors/screening in each visit; collaborate with sleep colleagues for referrals/visits; test for SDB with home sleep apnoea test, polysomnography; intervene with SDB-specific treatment (oral devices, continuous positive airway pressure, bilevel positive airway pressure, phrenic nerve and hypoglossal nerve stimulators) including risk factor modification (weight reduction, alcohol abstinence); continue ongoing assessment by cardiology and sleep teams for feedback about treatment; creating niche programmes for AF, heart failure and weight loss.