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

Winfried Randerath; Johan Verbraecken; Stefan Andreas; Michael Arzt; Konrad E Bloch; Thomas Brack; Bertien Buyse; Wilfried De Backer; Danny Joel Eckert; Ludger Grote; Lars Hagmeyer; Jan Hedner; Poul Jennum; Maria Teresa La Rovere; Carla Miltz; Walter T McNicholas; Josep Montserrat; Matthew Naughton; Jean-Louis Pepin; Dirk Pevernagie; Bernd Sanner; Dries Testelmans; Thomy Tonia; Bart Vrijsen; Peter Wijkstra; Patrick Levy

doi:10.1183/13993003.00959-2016

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

Winfried Randerath, Johan Verbraecken, Stefan Andreas, Michael Arzt, Konrad E Bloch, Thomas Brack, Bertien Buyse, Wilfried De Backer, Danny Joel Eckert, Ludger Grote, Lars Hagmeyer, Jan Hedner, Poul Jennum, Maria Teresa La Rovere, Carla Miltz, Walter T McNicholas, Josep Montserrat, Matthew Naughton, Jean-Louis Pepin, Dirk PevernagieBernd Sanner, Dries Testelmans, Thomy Tonia, Bart Vrijsen, Peter Wijkstra, Patrick Levy

Department of Clinical Medicine

105 Citations (Scopus)

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.

Original language	English
Article number	1600959
Journal	European Respiratory Journal
Volume	49
Issue number	1
Number of pages	28
ISSN	0903-1936
DOIs	https://doi.org/10.1183/13993003.00959-2016
Publication status	Published - 1 Jan 2017

Keywords

Advisory Committees
Analgesics, Opioid/therapeutic use
Europe
Humans
Hypoventilation/etiology
Polysomnography
Positive-Pressure Respiration
Practice Guidelines as Topic
Review Literature as Topic
Sleep
Sleep Apnea, Central/diagnosis

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Randerath, W., Verbraecken, J., Andreas, S., Arzt, M., Bloch, K. E., Brack, T., Buyse, B., De Backer, W., Eckert, D. J., Grote, L., Hagmeyer, L., Hedner, J., Jennum, P., La Rovere, M. T., Miltz, C., McNicholas, W. T., Montserrat, J., Naughton, M., Pepin, J-L., ... Levy, P. (2017). Definition, discrimination, diagnosis and treatment of central breathing disturbances during sleep. European Respiratory Journal, 49(1), [1600959]. https://doi.org/10.1183/13993003.00959-2016

Randerath, W, Verbraecken, J, Andreas, S, Arzt, M, Bloch, KE, Brack, T, Buyse, B, De Backer, W, Eckert, DJ, Grote, L, Hagmeyer, L, Hedner, J, Jennum, P, La Rovere, MT, Miltz, C, McNicholas, WT, Montserrat, J, Naughton, M, Pepin, J-L, Pevernagie, D, Sanner, B, Testelmans, D, Tonia, T, Vrijsen, B, Wijkstra, P & Levy, P 2017, 'Definition, discrimination, diagnosis and treatment of central breathing disturbances during sleep', European Respiratory Journal, vol. 49, no. 1, 1600959. https://doi.org/10.1183/13993003.00959-2016

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N2 - 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.

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JF - Acta tuberculosea Scandinavica

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ER -

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

Abstract

Keywords

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