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Pathophysiology of central sleep apneas
Adam B Hernandez1, Susheel P Patil2
1Division of Pulmonary, Critical Care and Sleep Medicine, One Gustave Levy Place, Mount Sinai Hospital, 17 East 102 Street Floor 6th Floor Room West Tower, New York, NY, 10029, USA. abh1497@gmail.com.
Sleep & Breathing = Schlaf & Atmung
|January 20, 2016
Summary
Central sleep apnea (CSA) involves breathing instability during sleep due to reduced respiratory drive. This review explores CSA pathophysiology, mechanisms, and clinical classifications for better understanding and treatment.
Area of Science:
- Sleep Medicine
- Respiratory Physiology
- Neurology
Background:
- Sleep onset triggers significant physiological changes affecting respiratory control.
- Sleep-related breathing disorders, including central sleep apneas (CSA), arise from these alterations.
- CSA is characterized by reduced or absent central respiratory drive, leading to airflow cessation.
Purpose of the Study:
- To provide an overview of normal breathing physiology during sleep.
- To discuss the pathophysiologic mechanisms underlying central sleep apnea.
- To explore mechanisms specific to different CSA manifestations.
Main Methods:
- Literature review of normal breathing physiology.
- Analysis of pathophysiologic mechanisms contributing to CSA.
- Examination of clinical classifications of CSA (eucapnic/hypocapnic vs. chronic hypercapnic).
Main Results:
- Ventilatory control instability is the hallmark of CSA.
- Additional mechanisms contribute to specific CSA presentations.
- CSA can occur in eucapnic/hypocapnic or chronic hypercapnic states, aiding in understanding pathophysiology and therapy.
Conclusions:
- Understanding the transition from wake to sleep is crucial for respiratory control.
- CSA pathophysiology is complex, involving ventilatory instability and other factors.
- Clinical classification aids in elucidating CSA mechanisms and guiding therapeutic strategies.
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