Chronic hypoventilation syndromes and sleep-related hypoventilation.
نویسندگان
چکیده
Chronic hypoventilation affects patients with disorders on any level of the respiratory system. The generation of respiratory impulses can be impaired in congenital disorders, such as central congenital alveolar hypoventilation, in alterations of the brain stem or complex diseases like obesity hypoventilation. The translation of the impulses via spinal cord and nerves to the respiratory muscles can be impaired in neurological diseases. Thoraco-skeletal or muscular diseases may inhibit the execution of the impulses. All hypoventilation disorders are characterized by a reduction of the minute ventilation with an increase of daytime hypercapnia. As sleep reduces minute ventilation substantially in healthy persons and much more pronounced in patients with underlying thoraco-pulmonary diseases, hypoventilation manifests firstly during sleep. Therefore, sleep related hypoventilation may be an early stage of chronic hypoventilation disorders. After treatment of any prevailing underlying disease, symptomatic therapy with non-invasive ventilation (NIV) is required. The adaptation of the treatment should be performed under close medical supervision. Pressure support algorithms have become most frequently used. The most recent devices automatically apply pressure support and vary inspiratory and expiratory pressures and breathing frequency in order to stabilize upper airways, normalize ventilation, achieve best synchronicity between patient and device and aim at optimizing patients' adherence.
منابع مشابه
Coexistence of obstructive sleep apnea and chronic obstructive pulmonary disease
Background: Obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) may lead to chronic alveolar hypoventilation. The coexistence of OSA and COPD has been termed the ‘overlap syndrome’. The aim of the study was to determine the relationship between the severity of COPD and the occurrence of chronic alveolar hypoventilation in patients with OSA and to evaluate the impact o...
متن کاملRespiratory mechanics and ventilatory control in overlap syndrome and obesity hypoventilation
The overlap syndrome of obstructive sleep apnoea (OSA) and chronic obstructive pulmonary disease (COPD), in addition to obesity hypoventilation syndrome, represents growing health concerns, owing to the worldwide COPD and obesity epidemics and related co-morbidities. These disorders constitute the end points of a spectrum with distinct yet interrelated mechanisms that lead to a considerable hea...
متن کاملCardiac Tone in Sleep Related Alveolar Hypoventilation
933 Heart Rate Variability in Sleep Related Alveolar Hypoventilation—Palma et al INTRODUCTION Sleep related alveolar hypoventilation (SRAH) is characterized by decreased alveolar ventilation resulting in sleep related oxygen arterial desaturation in patients with normal mechanical properties of the lung. SRAH can be distinguished from central and obstructive sleep apnea (OSA) by the fact that O...
متن کاملChronic hypoventilation and its management.
While obstructive sleep apnoea syndrome dominates discussion of the prevalence of sleep disordered breathing, nocturnal hypoventilation remains extremely prevalent in those with chronic ventilatory disorders and in the natural history of these conditions pre-dates the development of daytime ventilatory failure. In this review the clinical management of chronic hypoventilation in neuromuscular d...
متن کاملState of the Art
Introduction Normal Physiology during Sleep: Changes with Maturation and Development Changes in Respiration during Sleep Thoracic Mechanics Upper Airway Ventilatory Control Arousal Apnea Gas Exchange Obstructive Sleep Apnea Syndrome Epidemiology Pathophysiology Complications Evaluation Treatment Long-term Outcome Central Hypoventilation Syndromes Definition Etiology Evaluation Treatment Chronic...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Journal of thoracic disease
دوره 7 8 شماره
صفحات -
تاریخ انتشار 2015