Rasche K, Orth M, Schultze-Werninghaus G
Abteilung für Pneumologie und Allergologie, Ruhr-Universität Bochum.
Pneumologie. 1993 Dec;47 Suppl 4:738-40.
Central sleep apnoea syndromes (cSAS) represent a heterogeneous group of sleep-related disorders of breathing during sleep. cSAS may develop in the course of neurological syndromes or congestive heart failure. Frequency increases with age. A case of a 89-year old man is reported who was sent to hospital because of a state of confusion. He fell asleep all day with periods of restlessness during night. Sleep-related apnoeas could already be observed during daytime. Cardiopulmonary daytime diagnostics did not reveal any abnormal findings. Polysomnographic measurements, however, showed an apnoea-hypopnoea index of 37.8 apnoeas/hypopnoeas per hour with predominantly central apnoeas. Pernasal application of 1 litre of oxygen per minute during sleep normalised breathing patterns, daytime sleepiness, and the nighttime states of confusion stopped. Consequently, sleep-related disorders of breathing have to be considered in the differential diagnostics of unclear states of confusion in old age. In these cases polysomnography is indicated even in geriatric patients.
中枢性睡眠呼吸暂停综合征（cSAS）是一组与睡眠期间呼吸相关的异质性疾病。cSAS可能在神经综合征或充血性心力衰竭过程中发生。发病率随年龄增长而增加。报告了一例89岁男性因意识模糊状态被送往医院的病例。他白天整日嗜睡，夜间有烦躁不安的时段。白天即可观察到与睡眠相关的呼吸暂停。白天心肺检查未发现任何异常结果。然而，多导睡眠图测量显示呼吸暂停低通气指数为每小时37.8次呼吸暂停/低通气，主要为中枢性呼吸暂停。睡眠期间每分钟经鼻给予1升氧气可使呼吸模式正常化，白天嗜睡情况改善，夜间意识模糊状态停止。因此，在老年患者不明原因意识模糊的鉴别诊断中，必须考虑与睡眠相关的呼吸障碍。在这些情况下，即使是老年患者也需要进行多导睡眠图检查。
