Universität zu Köln

Herkenrath, Simon Dominik and Randerath, Winfried Johannes (2019). More than Heart Failure: Central Sleep Apnea and Sleep-Related Hypoventilation. Respiration, 98 (2). S. 95 - 111. BASEL: KARGER. ISSN 1423-0356

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Abstract

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. (C) 2019 S. Karger AG, Basel

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Herkenrath, Simon Dominik UNSPECIFIED UNSPECIFIED UNSPECIFIED Randerath, Winfried Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-160743
DOI:	10.1159/000500728
Journal or Publication Title:	Respiration
Volume:	98
Number:	2
Page Range:	S. 95 - 111
Date:	2019
Publisher:	KARGER
Place of Publication:	BASEL
ISSN:	1423-0356
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language POSITIVE AIRWAY PRESSURE; ADAPTIVE SERVO-VENTILATION; CHEYNE-STOKES RESPIRATION; RANDOMIZED CONTROLLED-TRIAL; INTENSITY NONINVASIVE VENTILATION; ACUTE ISCHEMIC-STROKE; CARBON-DIOXIDE; AUTO-SERVOVENTILATION; BREATHING DISORDERS; INCREASED MORTALITY Multiple languages Respiratory System Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/16074