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中枢性睡眠呼吸暂停:强调识别和鉴别。

Central sleep apnea: emphasizing recognition and differentiation.

机构信息

Department of Pneumology, Leuven University Center for Sleep and Wake disorders, University Hospitals Leuven, Leuven, Belgium.

Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium.

出版信息

Expert Rev Respir Med. 2024 May;18(5):309-320. doi: 10.1080/17476348.2024.2369256. Epub 2024 Jun 18.

Abstract

INTRODUCTION

Central sleep apnea (CSA) is a sleep-related breathing disorder in which the effort to breathe is intermittently diminished or absent. CSA is a common disorder among patients with different cardiovascular disorders, including heart failure. In addition, a growing number of medications have been shown to induce CSA and CSA can emerge after initiation of treatment for obstructive sleep apnea. Accumulating evidence shows that CSA is a heterogeneous disorder with individual differences in clinical and biological characteristics and/or underlying pathophysiological mechanisms.

AREAS COVERED

This narrative review offers an overview of the diagnostic aspects and classification of CSA, with an emphasis on heart failure patients, patients with CSA due to a medication and treatment-emergent CSA. The importance of evaluation of prognostic biomarkers in patients with different types of CSA is discussed. This narrative review synthesizes literature on CSA sourced from the PubMed database up to February 2024.

EXPERT OPINION

CSA presents a remarkably diverse disorder, with treatment modalities exhibiting potentially varied efficacy across its various phenotypes. This highlights the imperative for tailored management strategies that are rooted in phenotype classification.

摘要

简介

中枢性睡眠呼吸暂停(CSA)是一种与睡眠相关的呼吸障碍,其呼吸努力会间歇性减弱或停止。CSA 是患有不同心血管疾病(包括心力衰竭)的患者中常见的疾病。此外,越来越多的药物已被证明可诱发 CSA,并且 CSA 可在开始治疗阻塞性睡眠呼吸暂停后出现。越来越多的证据表明,CSA 是一种具有个体差异的异质性疾病,在临床和生物学特征和/或潜在的病理生理机制方面存在差异。

涵盖领域

本综述性文章概述了 CSA 的诊断方面和分类,重点介绍了心力衰竭患者、因药物引起 CSA 的患者和治疗后出现 CSA 的患者。还讨论了评估不同类型 CSA 患者预后生物标志物的重要性。本综述性文章综合了截至 2024 年 2 月来自 PubMed 数据库的关于 CSA 的文献。

专家意见

CSA 表现出一种非常多样化的疾病,治疗方式在其各种表型中表现出潜在的疗效差异。这凸显了需要基于表型分类制定量身定制的管理策略的必要性。

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