Via practica 7-8/2007

SLEEP RELATED BREATHING DISORDERS

Sleep apnea is characterized by repetitive apneic episodes accompanied with oxygen desaturations and arousals from sleep. Depending on the pathogenesis and polysomnographic finding, we distinguish three types of sleep apnea: obstructive, central and mixed sleep apnea. Repetitive apneic episodes cause sleep fragmentation and disrupt the normal physiologic interactions between sleep, respiratory and cardiovascular system with adverse impact on prognosis. Obstructive sleep apnea is commonly associated with obesity. It is a risk factor of cardiovascular diseases such as arterial hypertension, heart failure, arrhythmias and stroke. Central sleep apnea is considered to be a marker of left ventricular heart failure. Polysomnography is required to diagnose sleep apnea. Treatment of sleep apnea depends on the severity of sleep related breathing disorder. Surgical corrections are recommended only for patients with mild obstructive sleep apnea. The gold standard for effective treatment of moderate to severe sleep apnea is noninvasive ventilation.

Keywords: sleep related breathing disorders, obstructive sleep apnea, central sleep apnea, polysomnography, noninvasive ventilation.