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Eur Respir J. 2017 Jan 18;49(1). pii: 1600959. doi: 10.1183/13993003.00959-2016. Print 2017 Jan.

Definition, discrimination, diagnosis and treatment of central breathing disturbances during sleep.

Author information

1
Bethanien Hospital, Institute of Pneumology at the University of Cologne, Solingen, Germany randerath@klinik-bethanien.de.
2
These authors contributed equally.
3
Task force chairs.
4
Dept of Pulmonary Medicine, Antwerp University Hospital and University of Antwerp, Edegem, Belgium.
5
Cardiology and Pneumology, University Medical Center Göttingen, Göttingen, Germany.
6
Lung Clinic Immenhausen, Krs. Kassel, Germany.
7
Dept of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany.
8
University Hospital Zurich, Dept of Pulmonology and Sleep Disorders Center, Zurich, Switzerland.
9
Dept of Internal and Pulmonary Medicine, Kantonsspital Glarus, Glarus, Switzerland.
10
Dept of Pulmonary Medicine, KU Leuven, Leuven, Belgium.
11
Neuroscience Research Australia (NeuRA) and the University of New South Wales, Sydney, Australia.
12
Sleep Disorders Center, Dept of Pulmonary Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
13
Bethanien Hospital, Institute of Pneumology at the University of Cologne, Solingen, Germany.
14
Center for Healthy Aging and Danish Center for Sleep Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
15
Dept of Cardiology, Fondazione S. Maugeri, IRCCS, Istituto Scientifico di Montescano, Pavia, Italy.
16
Pulmonary and Sleep Disorders Unit, St Vincent's University Hospital and University College Dublin, Dublin, Ireland.
17
Laboratori del Son, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.
18
General Respiratory and Transplantation, Alfred Hospital and Monash University, Melbourne, Australia.
19
Laboratoire du sommeil explorations fonct. respire., Centre Hospitalier Universitaire Grenoble, Grenoble, France.
20
Sleep Medicine Center Kempenhaeghe, Heeze, The Netherlands.
21
Dept of Internal Medicine, Agaplesion Bethesda Hospital Wuppertal, Wuppertal, Germany.
22
Institute of Social and Preventive Medicine, Universtity of Bern, Bern, Switzerland.
23
Dept of Pulmonology/Home Mechanical Ventilation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

Abstract

The complexity of central breathing disturbances during sleep has become increasingly obvious. They present as central sleep apnoeas (CSAs) and hypopnoeas, periodic breathing with apnoeas, or irregular breathing in patients with cardiovascular, other internal or neurological disorders, and can emerge under positive airway pressure treatment or opioid use, or at high altitude. As yet, there is insufficient knowledge on the clinical features, pathophysiological background and consecutive algorithms for stepped-care treatment. Most recently, it has been discussed intensively if CSA in heart failure is a "marker" of disease severity or a "mediator" of disease progression, and if and which type of positive airway pressure therapy is indicated. In addition, disturbances of respiratory drive or the translation of central impulses may result in hypoventilation, associated with cerebral or neuromuscular diseases, or severe diseases of lung or thorax. These statements report the results of an European Respiratory Society Task Force addressing actual diagnostic and therapeutic standards. The statements are based on a systematic review of the literature and a systematic two-step decision process. Although the Task Force does not make recommendations, it describes its current practice of treatment of CSA in heart failure and hypoventilation.

PMID:
27920092
DOI:
10.1183/13993003.00959-2016
[Indexed for MEDLINE]
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