Sanner B, Schäfer T
Medizinische Klinik am Bethesda Krankenhaus Wuppertal.
Dtsch Med Wochenschr. 2008 Apr;133(14):722-6. doi: 10.1055/s-2008-1067316.
Central sleep apnea (CSA) is characterized by a lack of drive to inspire for at least 10 sec. In the CSA-syndrome accompanying arousals and desaturations of the arterial blood cause sleep disturbances and sympathetic nerve activations which lead to excessive daytime sleepiness and increase the risk for cardiovascular morbidity. There are six manifestations of CSA: a rare primary or idiopathic form, often in hypocapnic patients with an increased hypercapnic ventilatory drive; Cheyne-Stokes respiration, characterised by periodic CSA and a crescendo/decrescendo breathing pattern, often in patients with severe cardiac or neurological diseases; high altitude-induced periodic breathing (above 4000 m), CSA due to medical or neurological conditions; CSA due to drug or substance use; and primary sleep apnea of infancy. Besides the consequent treatment of the underlying medical conditions therapeutic options include the use of drugs, e. g. acetacolamide or oxygen, as well as non-invasive ventilation, e. g. continuous positive airway pressure (CPAP) or adaptive servo-ventilation.
中枢性睡眠呼吸暂停(CSA)的特征是缺乏吸气驱动力至少10秒。在伴有觉醒和动脉血氧饱和度下降的CSA综合征中,会导致睡眠障碍和交感神经激活,进而引起日间过度嗜睡,并增加心血管疾病的发病风险。CSA有六种表现形式:一种罕见的原发性或特发性形式,常见于低碳酸血症且高碳酸通气驱动增加的患者;潮式呼吸,其特征为周期性CSA和呼吸强度渐强/渐弱模式,常见于患有严重心脏或神经疾病的患者;高原性周期性呼吸(海拔4000米以上)、因医学或神经疾病导致的CSA、因药物或物质使用导致的CSA以及婴儿原发性睡眠呼吸暂停。除了对潜在疾病进行相应治疗外,治疗选择还包括使用药物,如乙酰唑胺或氧气,以及无创通气,如持续气道正压通气(CPAP)或适应性伺服通气。