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Central Sleep Apnea

delete2013-01-01
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PRE
AI
S
Shahrokh Javaheri *
J
Jerome A. Dempsey
DOI:10.1002/cphy.c110057delete
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摘要

摘要

En 中文
Neurophysiologically, central apnea is due to a temporary failure in the pontomedullary pacemaker generating breathing rhythm. As a polysomnographic finding, central apneas occur in many pathophysiological conditions. Depending on the cause or mechanism, central apneas may not be clinically significant, for example, those that occur normally at sleep onset. In contrast, central apneas occur in a number of disorders and result in pathophysiological consequences. Central apneas occur commonly in high-altitude sojourn, disrupt sleep, and cause desaturation. Central sleep apnea also occurs in number of disorders across all age groups and both genders. Common causes of central sleep apnea in adults are congestive heart failure and chronic use of opioids to treat pain. Under such circumstances, diagnosis and treatment of central sleep apnea may improve quality of life, morbidity, and perhaps mortality. The mechanisms of central sleep apnea have been best studied in congestive heart failure and hypoxic conditions when there is increased CO2 sensitivity below eupnea resulting in lowering eupneic PCO2 below apneic threshold causing cessation of breathing until the PCO2 rises above the apneic threshold when breathing resumes. In many other disorders, the mechanism of central sleep apnea (CSA) remains to be investigated. (C) 2013 American Physiological Society. Compr Physiol 3:141-163, 2013.
Keyword:
POSITIVE AIRWAY PRESSURE
CHEYNE-STOKES RESPIRATION
PRIMARY ALVEOLAR HYPOVENTILATION
CONGESTIVE-HEART-FAILURE
CEREBRAL-BLOOD-FLOW
PRIMARY PULMONARY-HYPERTENSION
INSPIRATORY MOTOR OUTPUT
EYE-MOVEMENT SLEEP
CAROTID-BODY
CARBON-DIOXIDE

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