TY - JOUR

T1 - Definition, discrimination, diagnosis and treatment of central breathing disturbances during sleep

AU - Randerath, Winfried

AU - Verbraecken, Johan

AU - Andreas, Stefan

AU - Arzt, Michael

AU - Bloch, Konrad E

AU - Brack, Thomas

AU - Buyse, Bertien

AU - De Backer, Wilfried

AU - Eckert, Danny Joel

AU - Grote, Ludger

AU - Hagmeyer, Lars

AU - Hedner, Jan

AU - Jennum, Poul

AU - La Rovere, Maria Teresa

AU - Miltz, Carla

AU - McNicholas, Walter T

AU - Montserrat, Josep

AU - Naughton, Matthew

AU - Pepin, Jean-Louis

AU - Pevernagie, Dirk

AU - Sanner, Bernd

AU - Testelmans, Dries

AU - Tonia, Thomy

AU - Vrijsen, Bart

AU - Wijkstra, Peter

AU - Levy, Patrick

N1 - Copyright ©ERS 2017.

PY - 2017

Y1 - 2017

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.

AB - 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.

KW - Advisory Committees

KW - Analgesics, Opioid/therapeutic use

KW - Europe

KW - Humans

KW - Hypoventilation/etiology

KW - Polysomnography

KW - Positive-Pressure Respiration

KW - Practice Guidelines as Topic

KW - Review Literature as Topic

KW - Sleep

KW - Sleep Apnea, Central/diagnosis

U2 - 10.1183/13993003.00959-2016

DO - 10.1183/13993003.00959-2016

M3 - Journal article

C2 - 27920092

VL - 49

JO - The European Respiratory Journal

JF - The European Respiratory Journal

SN - 0903-1936

IS - 1

M1 - 1600959

ER -