More than Heart Failure: Central Sleep Apnea and Sleep-Related Hypoventilation
| Autor: | Simon Herkenrath, Winfried Randerath |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Pulmonary and Respiratory Medicine
Sleep related hypoventilation medicine.medical_specialty Central sleep apnea Polysomnography Hypercapnia medicine Humans Obesity Intensive care medicine Heart Failure Continuous Positive Airway Pressure business.industry Altitude Oxygen Inhalation Therapy Hypoventilation medicine.disease Sleep in non-human animals Sleep Apnea Central Analgesics Opioid Stroke Hypoventilation syndromes Heart failure Periodic breathing Breathing medicine.symptom business |
| Zdroj: | Respiration; international review of thoracic diseases. 98(2) |
| ISSN: | 1423-0356 |
| Popis: | Central sleep apnea (CSA) comprises a variety of breathing patterns and clinical entities. They can be classified into 2 categories based on the partial pressure of carbon dioxide in the arterial blood. Nonhypercapnic CSA is usually characterized by a periodic breathing pattern, while hypercapnic CSA is based on hypoventilation. The latter CSA form is associated with central nervous, neuromuscular, and rib cage disorders as well as obesity and certain medication or substance intake. In contrast, nonhypercapnic CSA is typically accompanied by an overshoot of the ventilation and often associated with heart failure, cerebrovascular diseases, and stay in high altitude. CSA and hypoventilation syndromes are often considered separately, but pathophysiological aspects frequently overlap. An integrative approach helps to recognize underlying pathophysiological mechanisms and to choose adequate therapeutic strategies. Research in the last decades improved our insights; nevertheless, diagnostic tools are not always appropriately chosen to perform comprehensive sleep studies. This supports misinterpretation and misclassification of sleep disordered breathing. The purpose of this article is to highlight unresolved problems, raise awareness for different pathophysiological components and to discuss the evidence for targeted therapeutic strategies. |
| Databáze: | OpenAIRE |
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