Central sleep apnea: Pathophysiology and treatment

Chest

Volumn 131, Issue 2, 2007, Pages 595-607

  Eckert, Danny J ^a,b   Jordan, Amy S ^a   Merchia, Pankaj ^a   Malhotra, Atul ^b  

^a HARVARD MEDICAL SCHOOL   (United States)

^b BRIGHAM AND WOMEN S HOSPITAL   (United States)

Author keywords

Apnea threshold; Arousal; Chemoresponsiveness; Control of breathing; Hypercapnia; Hypoxia; Sleep disordered breathing

Indexed keywords

ACETAZOLAMIDE; CARBONATE DEHYDRATASE INHIBITOR; NARCOTIC AGENT; OPIATE; PROGESTERONE; THEOPHYLLINE;

ALTITUDE DISEASE; APNEA; AROUSAL; ARTERIAL CARBON DIOXIDE TENSION; ARTERIAL OXYGEN TENSION; BACKACHE; CARDIAC RESYNCHRONIZATION THERAPY; CAROTID BODY; CENTRAL SLEEP APNEA SYNDROME; CHEMORECEPTOR; CHEYNE STOKES BREATHING; CHRONIC PAIN; CLINICAL PRACTICE; DISEASE EXACERBATION; DISEASE SEVERITY; DRUG DOSE REDUCTION; DRUG INDUCED DISEASE; DRUG MEGADOSE; HEART FAILURE; HEART FUNCTION; HUMAN; HYPERCAPNIA; HYPOCAPNIA; IDIOPATHIC DISEASE; NON INVASIVE PROCEDURE; OBESITY HYPOVENTILATION SYNDROME; OXYGEN THERAPY; PATHOPHYSIOLOGY; POSITIVE END EXPIRATORY PRESSURE; PRACTICE GUIDELINE; PREVALENCE; PRIORITY JOURNAL; RESPIRATION CONTROL; RESPIRATION DEPRESSION; SHORT SURVEY; SLEEP APNEA SYNDROME; SLEEP WAKING CYCLE; TREATMENT INDICATION; WEIGHT REDUCTION;

EID: 33847120392     PISSN: 00123692     EISSN: None     Source Type: Journal    
DOI: 10.1378/chest.06.2287     Document Type: Article

References (128)

1. Lanfranchi PA, Somers VK, Braghiroli A, et al. Central sleep apnea in left ventricular dysfunction: prevalence and implications for arrhythmic risk. Circulation 2003; 107:727-732
2. Javaheri S, Parker TJ, Liming JD, et al. Sleep apnea in 81 ambulatory male patients with stable heart failure: types and their prevalences, consequences, and presentations. Circulation 1998; 97:2154-2159
3. White DP, Gleeson K, Pickett CK, et al. Altitude acclimatization: influence on periodic breathing and chemoresponsiveness during sleep. J Appl Physiol 1987; 63:401-412
4. Poulain M, Doucet M, Major GC, et al. The effect of obesity on chronic respiratory diseases: pathophysiology and therapeutic strategies. Can Med Assoc J 2006; 174:1293-1299
5. Malhotra A, Berry RB, White DP. Central sleep apnea. In: Carney PR, Berry RB, Geyer JD, eds. Clinical sleep disorders. Philadelphia, PA: Lippincott Williams and Wilkins, 2004; 331-346
6. Javaheri S. Sleep disorders in systolic heart failure: a prospective study of 100 male patients: the final report. Int J Cardiol 2006; 106:21-28
7. Badr MS, Toiber F, Skatrud JB, et al. Pharyngeal narrowing/occlusion during central sleep apnea. J Appl Physiol 1995; 78:1806-1815
8. Khoo MC, Kronauer RE, Strohl KP, et al. Factors inducing periodic breathing in humans: a general model. J Appl Physiol 1982; 53:644-659
9. White DP. Pathogenesis of obstructive and central sleep apnea. Am J Respir Crit Care Med 2005; 172:1363-1370
10. Wellman A, Malhotra A, Fogel RB, et al. Respiratory system loop gain in normal men and women measured with proportional-assist ventilation. J Appl Physiol 2003; 94:205-212
11. Orem J. The nature of the wakefulness stimulus for breathing. Prog Clin Biol Res 1990; 345:23-30; discussion 31
12. Burgess HJ, Kleiman J, Trinder J. Cardiac activity during sleep onset. Psychophysiology 1999; 36:298-306
13. Trinder J, Whitworth F, Kay A, et al. Respiratory instability during sleep onset. J Appl Physiol 1992; 73:2462-2469
14. Skatrud JB, Berssenbrugge AD. Effect of sleep state and chemical stimuli on breathing. Prog Clin Biol Res 1983; 136:87-95
15. Kay A, Trinder J, Bowes G, et al. Changes in airway resistance during sleep onset. J Appl Physiol 1994; 76:1600-1607
16. Worsnop C, Kay A, Pierce R, et al. Activity of respiratory pump and upper airway muscles during sleep onset. J Appl Physiol 1998; 85:908-920
17. Dunai J, Wilkinson M, Trinder J. Interaction of chemical and state effects on ventilation during sleep onset. J Appl Physiol 1996; 81:2235-2243
18. Khoo MC, Gottschalk A, Pack AI. Sleep-induced periodic breathing and apnea: a theoretical study. J Appl Physiol 1991; 70:2014-2024
19. Dunai J, Kleiman J, Trinder J. Ventilatory instability during sleep onset in individuals with high peripheral chemosensitivity. J Appl Physiol 1999; 87:661-672
20. Meza S, Mendez M, Ostrowski M, et al. Susceptibility to periodic breathing with assisted ventilation during sleep in normal subjects. J Appl Physiol 1998; 85:1929-1940
21. Skatrud JB, Dempsey JA. Interaction of sleep state and chemical stimuli in sustaining rhythmic ventilation. J Appl Physiol 1983; 55:813-822
22. Dempsey JA. Crossing the apnoeic threshold: causes and consequences. Exp Physiol 2005; 90:13-24
23. White DP, Douglas NJ, Pickett CK, et al. Hypoxic ventilatory response during sleep in normal premenopausal women. Am Rev Respir Dis 1982; 126:530-533
24. Douglas NJ, White DP, Weil JV, et al. Hypoxic ventilatory response decreases during sleep in normal men. Am Rev Respir Dis 1982; 125:286-289
25. Wiegand L, Zwillich CW, White DP. Sleep and the ventilatory response to resistive loading in normal men. J Appl Physiol 1988; 64:1186-1195
26. 2 retention and respiratory muscle activity during NREM sleep. J Appl Physiol 1988; 65:1676-1685
27. Gugger M, Bogershausen S, Schaffler L. Arousal responses to added inspiratory resistance during REM and non-REM sleep in normal subjects. Thorax 1993; 48:125-129
28. Homer RL, Rivera MP, Kozar LF, et al. The ventilatory response to arousal from sleep is not fully explained by differences in CO(2) levels between sleep and wakefulness. J Physiol 2001; 534:881-890
29. Trinder J, Padula M, Berlowitz D, et al. Cardiac and respiratory activity at arousal from sleep under controlled ventilation conditions. J Appl Physiol 2001; 90:1455-1463
30. Xie A, Wong B, Phillipson EA, et al. Interaction of hyperventilation and arousal in the pathogenesis of idiopathic central sleep apnea. Am J Respir Crit Care Med 1994; 150:489-495
31. Bradley TD, McNicholas WT, Rutherford R, et al. Clinical and physiologic heterogeneity of the central sleep apnea syndrome. Am Rev Respir Dis 1986; 134:217-221
32. American Thoracic Society. Idiopathic congenital central hypoventilation syndrome: diagnosis and management. Am J Respir Crit Care Med 1999; 160:368-373
33. Weese-Mayer DE, Silvestri JM, Menzies LJ, et al. Congenital central hypoventilation syndrome: diagnosis, management, and long-term outcome in thirty-two children. J Pediatr 1992; 120:381-387
34. Fleming PJ, Cade D, Bryan MH, et al. Congenital central hypoventilation and sleep state. Pediatrics 1980; 66:425-428
35. Antic NA, Malow BA, Lange N, et al. PHOX2B mutation-confirmed congenital central hypoventilation syndrome: presentation in adulthood. Am J Respir Crit Care Med 2006; 174:923-927
36. Santiago TV, Edelman NH. Opioids and breathing. J Appl Physiol 1985; 59:1675-1685
37. Shook JE, Watkins WD, Camporesi EM. Differential roles of opioid receptors in respiration, respiratory disease, and opiate-induced respiratory depression. Am Rev Respir Dis 1990; 142:895-909
38. The use of opioids for the treatment of chronic pain: a consensus statement from the American Academy of Pain Medicine and the American Pain Society. Clin J Pain 1997; 13:6-8
39. Farney RJ, Walker JM, Cloward TV, et al. Sleep-disordered breathing associated with long-term opioid therapy. Chest 2003; 123:632-639
40. Wang D, Teichtahl H, Drummer O, et al. Central sleep apnea in stable methadone maintenance treatment patients. Chest 2005; 128:1348-1356
41. Elliott AM, Smith BH, Penny KI, et al. The epidemiology of chronic pain in the community. Lancet 1999; 354:1248-1252
42. Luo X, Pietrobon R, Hey L. Patterns and trends in opioid use among individuals with back pain in the United States. Spine 2004; 29:884-890; discussion 891
43. Weil JV, McCullough RE, Kline JS, et al. Diminished ventilatory response to hypoxia and hypercapnia after morphine in normal man. N Engl J Med 1975; 292:1103-1106
44. Teichtahl H, Wang D, Cunnington D, et al. Ventilatory responses to hypoxia and hypercapnia in stable methadone maintenance treatment patients. Chest 2005; 128:1339-1347
45. Zwillich CW, Sutton FD, Pierson DJ, et al. Decreased hypoxic ventilatory drive in the obesity-hypoventilation syndrome. Am J Med 1975; 59:343-348
46. Olson AL, Zwillich C. The obesity hypoventilation syndrome. Am J Med 2005; 118:948-956
47. Strumpf DA, Millman RP, Hill NS. The management of chronic hypoventilation. Chest 1990; 98:474-480
48. Sampson MG, Grassino K. Neuromechanical properties in obese patients during carbon dioxide rebreathing. Am J Med 1983; 75:81-90
49. Sharp JT, Henry JP, Sweany SK, et al. Effects of mass loading the respiratory system in man. J Appl Physiol 1964; 19:959-966
50. Shimura R, Tatsumi K, Nakamura A, et al. Fat accumulation, leptin, and hypercapnia in obstructive sleep apnea-hypopnea syndrome. Chest 2005; 127:543-549
51. O'Donnell CP, Schaub CD, Haines AS, et al. Leptin prevents respiratory depression in obesity. Am J Respir Crit Care Med 1999; 159:1477-1484
52. Phipps PR, Starritt E, Caterson I, et al. Association of serum leptin with hypoventilation in human obesity. Thorax 2002; 57:75-76
53. Trinder J, Merson R, Rosenberg JI, et al. Pathophysiological interactions of ventilation, arousals, and blood pressure oscillations during Cheyne-Stokes respiration in patients with heart failure. Am J Respir Crit Care Med 2000; 162:808-813
54. Szollosi I, Roebuck T, Thompson B, et al. Lateral sleeping position reduces severity of central sleep apnea/Cheyne-Stokes respiration. Sleep 2006; 29:1045-1051
55. Naughton M, Benard D, Tam A, et al. Role of hyperventilation in the pathogenesis of central sleep apneas in patients with congestive heart failure. Am Rev Respir Dis 1993; 148:330-338
56. Solin P, Roebuck T, Johns DP, et al. Peripheral and central ventilatory responses in central sleep apnea with and without congestive heart failure. Am J Respir Crit Care Med 2000; 162:2194-2200
57. 2 in patients with congestive heart failure. Am J Respir Crit Care Med 2002; 165:1245-1250
58. Hall MJ, Xie A, Rutherford R, et al. Cycle length of periodic breathing in patients with and without heart failure. Am J Respir Crit Care Med 1996; 154:376-381
59. Xie A, Skatrud JB, Khayat R, et al. Cerebrovascular response to carbon dioxide in patients with congestive heart failure. Am J Respir Crit Care Med 2005; 172:371-378
60. Paintal AS. Vagal sensory receptors and their reflex effects. Physiol Rev 1973; 53:159-227
61. Solin P, Bergin P, Richardson M, et al. Influence of pulmonary capillary wedge pressure on central apnea in heart failure. Circulation 1999; 99:1574-1579
62. Bradley TD, Phillipson EA. Central sleep apnea. Clin Chest Med 1992; 13:493-505
63. Solin P, Jackson DM, Roebuck T, et al. Cardiac diastolic function and hypercapnic ventilatory responses in central sleep apnoea. Eur Respir J 2002; 20:717-723
64. Xie A, Rutherford R, Rankin F, et al. Hypocapnia and increased ventilatory responsiveness in patients with idiopathic central sleep apnea. Am J Respir Crit Care Med 1995; 152:1950-1955
65. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research: the report of an American Academy of Sleep Medicine Task Force. Sleep 1999; 22:667-689
66. Khoo MC, Anholm JD, Ko SW, et al. Dynamics of periodic breathing and arousal during sleep at extreme altitude. Respir Physiol 1996; 103:33-43
67. Dempsey JA, Smith CA, Harms CA, et al. Sleep-induced breathing instability: University of Wisconsin-Madison Sleep and Respiration Research Group. Sleep 1996; 19:236-247
68. Hlavac MC, Catcheside PG, McDonald R, et al, Hypoxia impairs the arousal response to external resistive loading and airway occlusion during sleep. Sleep 2006; 29:624-631
69. Eckert DJ, Catcheside PG, McDonald R, et al. Sustained hypoxia depresses sensory processing of respiratory resistive loads. Am J Respir Crit Care Med 2005; 172:1047-1054
70. Xu F, Gu QH, Zhou T, et al. Acute hypoxia prolongs the apnea induced by right atrial injection of capsaicin. J Appl Physiol 2003; 94:1446-1454
71. Morgenthaler TI, Kagramanov V, Hanak V, et al. Complex sleep apnea syndrome: is it a unique clinical syndrome. Sleep 2006; 29:1203-1209
72. Gastrointestinal surgery for severe obesity: National Institutes of Health Consensus Development Conference statement. Am J Clin Nutr 1992; 55:6158-6198
73. Perez de Llano LA, Golpe R, Ortiz Piquer M, et al. Short-term and long-term effects of nasal intermittent positive pressure ventilation in patients with obesity-liypoventilation syndrome. Chest 2005; 128:587-594
74. Berger KI, Ayappa I, Chatr-Amontri B, et al. Obesity hypoventilation syndrome as a spectrum of respiratory disturbances during sleep. Chest 2001; 120:1231-1238
75. Hida W, Okabe S, Tatsumi K, et al. Nasal continuous positive airway pressure improves quality of life in obesity hypoventilation syndrome. Sleep Breath 2003; 7:3-12
76. Shneerson JM, Simonds AK. Noninvasive ventilation for chest wall and neuromuscular disorders, Eur Respir J 2002; 20:480-487
77. Storre JH, Seuthe B, Fiechter R, et al. Average volume-assured pressure support in obesity hypoventilation: a randomized crossover trial. Chest 2006; 130:815-821
78. McNicholas WT, Carter JL, Rutherford R, et al. Beneficial effect of oxygen in primary alveolar hypoventilation with central sleep apnea. Am Rev Respir Dis 1982; 125:773-775
79. Sutton FD Jr, Zwillich CW, Creagh CE, et al. Progesterone for outpatient treatment of Pickwickian syndrome. Ann Intern Med 1975; 83:476-479
80. Baylor P, Tayloe D, Owen D, et al. Cardiac failure presenting as sleep apnea: elimination of apnea following medical management of cardiac failure. Chest 1988; 94:1298-1300
81. Dark DS, Pingleton SK, Kerby GR, et al. Breathing pattern abnormalities and arterial oxygen desaturation during sleep in the congestive heart failure syndrome: improvement following medical therapy. Chest 1987; 91:833-836
82. Walsh JT, Andrews R, Starling R, et al. Effects of captopril and oxygen on sleep apnoea in patients with mild to moderate congestive cardiac failure. Br Heart J 1995; 73: 237-241
83. Bradley TD, Logan AG, Kimoff RJ, et al. Continuous positive airway pressure for central sleep apnea and heart failure. N Engl J Med 2005; 353:2025-2033
84. Teschler H, Dohring J, Wang YM, et al. Adaptive pressure support servo-ventilation: a novel treatment for Cheyne-Stokes respiration in heart failure. Am J Respir Crit Care Med 2001; 164:614-619
85. Philippe C, Stoica-Herman M, Drouot X, et al. Compliance with and effectiveness of adaptive servoventilation versus continuous positive airway pressure in the treatment of Cheyne-Stokes respiration in heart failure over a six month period. Heart 2006; 92:337-342
86. Pepperell JC, Maskell NA, Jones DR, et al. A randomized controlled trial of adaptive ventilation for Cheyne-Stokes breathing in heart failure. Am J Respir Crit Care Med 2003; 168:1109-1114
87. Pittman S, Hill P, Malhotra A, et al. Stabilizing Cheyne Stokes respiration associated with congestive heart failure using computer assisted positive airway pressure. Comput Cardiol 2000; 201-204
88. Lorenzi-Filho G, Rankin F, Bies I, et al. Effects of inhaled carbon dioxide and oxygen on Cheyne-Stokes respiration in patients with heart failure. Am J Respir Crit Care Med 1999; 159:1490-1498
89. Khayat RN, Xie A, Patel AK, et al. Cardiorespiratory effects of added dead space in patients with heart failure and central sleep apnea. Chest 2003; 123:1551-1560
90. Franklin KA, Eriksson P, Sahlin C, et al. Reversal of central sleep apnea with oxygen. Chest 1997; 111:163-169
91. 2 on sleep-related disordered breathing in ambulatory patients with stable heart failure. Sleep 1999; 22:1101-1106
92. Hanly PJ, Millar TW, Steljes DG, et al. The effect of oxygen on respiration and sleep in patients with congestive heart failure. Ann Intern Med 1989; 111:777-782
93. Krachman SL, D'Alonzo GE, Berger TJ, et al. Comparison of oxygen therapy with nasal continuous positive airway pressure on Cheyne-Stokes respiration during sleep in congestive heart failure. Chest 1999; 116:1550-1557
94. Sinha AM, Skobel EC, Breithardt OA, et al. Cardiac resynchronization therapy improves central sleep apnea and Cheyne-Stokes respiration in patients with chronic heart failure. J Am Coll Cardiol 2004; 44:68-71
95. Gabor JY, Newman DA, Barnard-Roberts V, et al. Improvement in Cheyne-Stokes respiration following cardiac resynchronisation therapy. Eur Respir J 2005; 26:95-100
96. Javaheri S, Parker TJ, Wexler L, et al. Effect of theophylline on sleep-disordered breathing in heart failure. N Engl J Med 1996; 335:562-567
97. Javaheri S. Acetazolamide improves central sleep apnea in heart failure: a double-blind, prospective study. Am J Respir Crit Care Med 2006; 173:234-237
98. Hoffstein V, Slutsky AS. Central sleep apnea reversed by continuous positive airway pressure. Am Rev Respir Dis 1987; 135:1210-1212
99. Issa FG, Sullivan CE. Reversal of central sleep apnea using nasal CPAP. Chest 1986; 90:165-171
100. 2 and added dead space on idiopathic central sleep apnea. J Appl Physiol 1997; 82:918-926
101. Garrigue S, Bordier P, Jais P, et al. Benefit of atrial pacing in sleep apnea syndrome. N Engl J Med 2002; 346:404-412
102. Melzer C, Fietze I, Duru F, et al. Nocturnal overdrive pacing for the treatment of sleep apnea syndrome. Sleep 2006; 29:1197-1202
103. Luthje L, Unterberg-Buchwald C, Dajani D, et al. Atrial overdrive pacing in patients with sleep apnea with implanted pacemaker. Am J Respir Crit Care Med 2005; 172:118-122
104. Unterberg C, Luthje L, Szych J, et al. Atrial overdrive pacing compared to CPAP in patients with obstructive sleep apnoea syndrome. Eur Heart J 2005; 26:2568-2575
105. Pepin JL, Defaye P, Garrigue S, et al. Overdrive atrial pacing does not improve obstructive sleep apnoea syndrome. Eur Respir J 2005; 25:343-347
106. Krahn AD, Yee R, Erickson MK, et al. Physiologic pacing in patients with obstructive sleep apnea: a prospective, randomized crossover trial. J Am Coll Cardiol 2006; 47:379-383
107. Simantirakis EN, Schiza SE, Chrysostomakis SI, et al. Atrial overdrive pacing for the obstructive sleep apnea-hypopnea syndrome. N Engl J Med 2005; 353:2568-2577
108. White DP, Zwillich CW, Pickett CK, et al. Central sleep apnea: improvement with acetazolamide therapy. Arch Intern Med 1982; 142:1816-1819
109. Mak S, Azevedo ER, Liu PP, et al. Effect of hyperoxia on left ventricular function and filling pressures in patients with and without congestive heart failure. Chest 2001; 120:467-473
110. Shigemitsu M, Nishio K, Kusuyama T, et al. Nocturnal oxygen therapy prevents progress of congestive heart failure with central sleep apnea. Int J Cardiol 2007 (in press)
111. Sasayama S, Izumi T, Seino Y, et al. Effects of nocturnal oxygen therapy on outcome measures in patients with chronic heart failure and Cheyne-Stokes respiration. Circ J 2006; 70:1-7
112. 2 on Cheyne-Stokes respiration in congestive heart failure. Sleep 1994; 17:61-68
113. 2 inhalation on central sleep apnea and arousals from sleep. Respiration 2004; 71:493-498
114. Andreas S, Weidel K, Hagenah G, et al. Treatment of Cheyne-Stokes respiration with nasal oxygen and carbon dioxide. Eur Respir J 1998; 12:414-419
115. Krachman SL, Crocetti J, Berger TJ, et al. Effects of nasal continuous positive airway pressure on oxygen body stores in patients with Cheyne-Stokes respiration and congestive heart failure. Chest 2003; 123:59-66
116. Arzt M, Bradley TD. Treatment of sleep apnea in heart failure. Am J Respir Crit Care Med 2006; 173:1300-1308
117. Hommura F, Nishimura M, Oguri M, et al. Continuous versus bilevel positive airway pressure in a patient with idiopathic central sleep apnea. Am J Respir Crit Care Med 1997; 155:1482-1485
118. Thomas RJ, Daly RW, Weiss JW. Low-concentration carbon dioxide is an effective adjunct to positive airway pressure in the treatment of refractory mixed central and obstructive sleep-disordered breathing. Sleep 2005; 28:69-77
119. Johnson KG, Johnson DC. Bilevel positive airway pressure worsens central apneas during sleep. Chest 2005; 128:2141-2150
120. Masa JF, Celli BR, Riesco JA, et al. The obesity hypoventilation syndrome can be treated with noninvasive mechanical ventilation. Chest 2001; 119:1102-1107
121. Collop NA. Cheyne-stokes ventilation converting to obstructive sleep apnea following heart transplantation. Chest 1993; 104:1288-1289
122. Mansfield DR, Solin P, Roebuck T, et al. The effect of successful heart transplant treatment of heart failure on central sleep apnea. Chest 2003; 124:1675-1681
123. Javaheri S, Abraham WT, Brown C, et al. Prevalence of obstructive sleep apnoea and periodic limb movement in 45 subjects with heart transplantation. Eur Heart J 2004; 25:260-266
124. Himmrich E, Przibille O, Zellerhoff C, et al. Proarrhythmic effect of pacemaker stimulation in patients with implanted cardioverter-deflbrillators. Circulation 2003; 108:192-197
125. Nakayama H, Smith CA, Rodman JR, et al. Effect of ventilatory drive on carbon dioxide sensitivity below eupnea during sleep. Am J Respir Crit Care Med 2002; 165:1251-1260
126. Zwillich CW, Natalino MR, Sutton FD, et al. Effects of progesterone on chemosensitivity in normal men. J Lab Clin Med 1978; 92:262-269
127. Bittar G, Friedman HS. The arrhythmogenicity of theophylline: a multivariate analysis of clinical determinants. Chest 1991; 99:1415-1420
128. Suissa S, Hemmelgarn B, Blais L, et al. Bronchodilators and acute cardiac death. Am J Respir Crit Care Med 1996; 154:1598-1602