Regn Dara D, Davis Anh H, Smith William D, Blasser Catherine J, Ford Caelan M
United States Air Force School of Aerospace Medicine, Wright-Patterson Air Force Base, Ohio.
Department of Aerospace Medicine, McConnell Air Force Base, Kansas.
Fed Pract. 2023 Mar;40(3):78-86. doi: 10.12788/fp.0367. Epub 2023 Mar 9.
While the literature has demonstrated a higher prevalence of moderate-to-severe obstructive sleep apnea (OSA) in the general population compared with central sleep apnea (CSA), more evidence is needed on the long-term clinical impact of and optimal treatment strategies for CSA.
CSA is overrepresented among certain clinical populations, such as those with heart failure, stroke, neuromuscular disorders, and opioid use. The clinical concerns with CSA parallel those of OSA. The absence of respiration (apneas and hypopneas due to lack of effort) results in sympathetic surge, compromise of oxygenation and ventilation, sleep fragmentation, and elevation in blood pressure. Symptoms such as excessive daytime sleepiness, morning headaches, witnessed apneas, and nocturnal arrhythmias are shared between the 2 disorders. A systematic clinical approach should be used to identify and treat CSA.
The purpose of this review is to familiarize the primary care community with CSA to aid in the identification and management of this breathing disturbance.
虽然文献表明，与中枢性睡眠呼吸暂停（CSA）相比，普通人群中中度至重度阻塞性睡眠呼吸暂停（OSA）的患病率更高，但仍需要更多关于CSA的长期临床影响和最佳治疗策略的证据。
CSA在某些临床人群中占比过高，如心力衰竭、中风、神经肌肉疾病和使用阿片类药物的人群。CSA的临床问题与OSA类似。呼吸停止（因努力不足导致的呼吸暂停和呼吸浅慢）会导致交感神经兴奋、氧合和通气功能受损、睡眠碎片化以及血压升高。这两种疾病都有白天过度嗜睡、晨起头痛、目击性呼吸暂停和夜间心律失常等症状。应采用系统的临床方法来识别和治疗CSA。
本综述的目的是让基层医疗界熟悉CSA，以帮助识别和管理这种呼吸障碍。
