Central Sleep Apnea & Cheyne-stokes

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Central Sleep Apnea

Web link <A HREF= " http://www.predictonline.com/sleep4.htm " >central sleep

apnea</A>

Central sleep apnea is not a single disease entity, but rather include

several disorders in which the common abnormality is the withdrawal of

effective central drive to the respiratory muscles.

In some people, recurrent central sleep apneas during sleep are not

associated with any clinical manifestation or physiologic disturbances. In

others, they present with symptoms of morning fatigue, daytime sleepiness,

morning headache, and recurrent nocturnal awakenings. One of the common form

of central apnea is known as Cheyne-stokes respiration. The Cheyne-srokes

respiration is a pattern of breathing characterized by deep inspiratory cycle

interchanged with complete cessation of breathing. This form of respiration

is commonly seen in patients with congestive heart failure, being present in

30% to 40%. Its presence indicates a shorter survival compared to those who

do not have this type of breathing.

Diagnosis

The diagnosis of Cheyne-Stokes respiration requires an overnight

polysomnography performed in a sleep laboratory. Screening tools for

Cheyne-Stokes respiration are under development (to be added soon).

Treatment

The first line of treatment is to optimize treatment for congestive heart

failure. The addition of angiotensin converting enzyme inhibitors, digoxin or

increasing the diuretics are among the potential therapeutic interventions.

Among those with persistent Cheyne-Stokes respiration, various forms of

continuous positive airways pressure (CPAP) have been advocated. The use of

CPAP has been shown to improve cardiac function, quality of life and reduce

the need for transplantation.

[Guest guest]

Central Sleep Apnea

Web link <A HREF= " http://www.predictonline.com/sleep4.htm " >central sleep

apnea</A>

Central sleep apnea is not a single disease entity, but rather include

several disorders in which the common abnormality is the withdrawal of

effective central drive to the respiratory muscles.

In some people, recurrent central sleep apneas during sleep are not

associated with any clinical manifestation or physiologic disturbances. In

others, they present with symptoms of morning fatigue, daytime sleepiness,

morning headache, and recurrent nocturnal awakenings. One of the common form

of central apnea is known as Cheyne-stokes respiration. The Cheyne-srokes

respiration is a pattern of breathing characterized by deep inspiratory cycle

interchanged with complete cessation of breathing. This form of respiration

is commonly seen in patients with congestive heart failure, being present in

30% to 40%. Its presence indicates a shorter survival compared to those who

do not have this type of breathing.

Diagnosis

The diagnosis of Cheyne-Stokes respiration requires an overnight

polysomnography performed in a sleep laboratory. Screening tools for

Cheyne-Stokes respiration are under development (to be added soon).

Treatment

The first line of treatment is to optimize treatment for congestive heart

failure. The addition of angiotensin converting enzyme inhibitors, digoxin or

increasing the diuretics are among the potential therapeutic interventions.

Among those with persistent Cheyne-Stokes respiration, various forms of

continuous positive airways pressure (CPAP) have been advocated. The use of

CPAP has been shown to improve cardiac function, quality of life and reduce

the need for transplantation.