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Chapter 13. Sleep-Related Breathing Disorders

Teofilo Lee-Chiong Jr., MD, FCCP
DOI: 10.1378/pulm.26.13
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Sections

Objectives 
  • Recognize the clinical features and consequences of sleep-disordered breathing.

  • Determine effective treatment options for sleep apnea.

  • Understand the mechanisms responsible for central sleep apnea.

Synopsis 

Obstructive sleep apnea (OSA) is characterized by repetitive cessation (apnea) or reduction (hypopnea) of airflow during sleep that develops despite the presence of respiratory efforts and that is caused by complete (apnea) or partial (hypopnea) upper airway occlusion during sleep. OSA is a systemic disorder with wide-ranging consequences on the cardiovascular, respiratory, renal, gastrointestinal, endocrine, neurocognitive, and immune functions if left untreated. Polysomnography is required for the diagnosis of OSA. Positive airway pressure therapy is the treatment of choice for most persons with OSA; other therapies include oral devices and upper airway surgery. Central sleep apnea is defined as repetitive cessation of airflow during sleep caused by loss of ventilatory effort. Central sleep apnea can be classified into hypercapnic and nonhypercapnic forms. Nocturnal hypoventilation syndromes are characterized by sleep-related oxygen desaturation and elevated Paco2 during sleep.

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