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Current Pulmonology Reports

Erschienen in:

13.03.2019 | Sleeping and Breathing (S Shafazand, Section Editor)

Central Sleep Apnea: a Brief Review

verfasst von: M. Safwan Badr, Shahrokh Javaheri

Erschienen in: Current Pulmonology Reports | Ausgabe 1/2019

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Abstract

Purpose of Review

The purpose of this review is to discuss the pathogenesis, clinical manifestations, diagnosis, and treatment, including areas of controversy and uncertainty.

Recent Findings

Central apnea may be due to hypoventilation or to hypocapnia following hyperventilation. The occurrence of central apnea initiates a cascade of events that perpetuates breathing instability, recurrent central apnea, and upper airway narrowing. In fact, breathing instability and upper airway narrowing are key elements of central and obstructive apnea. Clinically, central apnea is noted in association with obstructive sleep apnea, heart failure, atrial fibrillation, cerebrovascular accident tetraplegia, and chronic opioid use. Management strategies for central apnea aim to eliminate abnormal respiratory events, stabilize sleep, and alleviate the underlying clinical condition. Positive pressure therapy (PAP) remains a standard therapy for central as well as obstructive apnea. Other treatment options include adaptive servo-ventilation (ASV), supplemental oxygen, phrenic nerve stimulation, and pharmacologic therapy. However, ASV is contraindicated in patients with central sleep apnea who had heart failure with reduced ejection fraction, owing to increased mortality in this population.

Summary

There are several therapeutic options for central apnea. Randomized controlled studies are needed to ascertain the long-term effectiveness of individual, or combination, treatment modalities in different types of central apnea.

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Titel: Central Sleep Apnea: a Brief Review
verfasst von: M. Safwan Badr
Shahrokh Javaheri
Publikationsdatum: 13.03.2019
Verlag: Springer US
Erschienen in: Current Pulmonology Reports / Ausgabe 1/2019
Elektronische ISSN: 2199-2428
DOI: https://doi.org/10.1007/s13665-019-0221-z

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Central Sleep Apnea: a Brief Review

Abstract

Purpose of Review

Recent Findings

Summary

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Parodontalbehandlung verbessert Prognose bei Katheterablation

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Purpose of Review

Recent Findings

Summary

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Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Parodontalbehandlung verbessert Prognose bei Katheterablation

Antihypertensiva schützen auch alte Menschen noch vor Demenz

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Denken Sie bei starker Blutung auch an die Hemmkörper-Hämophilie

Update Innere Medizin