Abstract
The transition from wake to sleep is accompanied by a host of physiologic changes, which result in major alterations in respiratory control and may result in sleep-related breathing disorders. The central sleep apneas are a group of sleep-related breathing disorders that are characterized by recurrent episodes of airflow reduction or cessation due to a temporary reduction or absence of central respiratory drive. The fundamental hallmark of central sleep apnea (CSA) disorders is the presence of ventilatory control instability; however, additional mechanisms play a role in one or more specific manifestations of CSA. CSA may manifest during conditions of eucapnia/hypocapnia or chronic hypercapnia, which is a useful clinical classification that lends understanding to the underlying pathophysiology and potential therapies. In this review, an overview of normal breathing physiology is provided, followed by a discussion of pathophysiologic mechanisms that promote CSA and the mechanisms that are specific to different manifestations of CSA.
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Author AH has no conflicts of interest to report. Author SP is on the Medical Advisory Board for Somnomed.
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Hernandez, A.B., Patil, S.P. Pathophysiology of central sleep apneas. Sleep Breath 20, 467–482 (2016). https://doi.org/10.1007/s11325-015-1290-z
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DOI: https://doi.org/10.1007/s11325-015-1290-z