An overview of central sleep apnea with heart failure

The field is shifting from one size fits all apnea-hyponea index (AHI) suppression to phenotype-guided care, prioritizing patient centered and cardiac outcomes. Integrating endotyping, remote monitoring, and HF co-management is key. Major gaps include optimal patient selection, long-term cardiovascular endpoints, and harmonization of guideline recommendations. If optimization of HF therapy and a continuous positive airway pressure (CPAP) trial fail to improve symptoms, adaptive servoventilation (ASV) becomes the preferred therapeutical option.