title: Pathophysiology of central sleep apneas.
abstract: The transition from wake to sleep is accompanied by a host of physiologic changes, which result in major alterations in respiratory control and may result in sleep-related breathing disorders. The central sleep apneas are a group of sleep-related breathing disorders that are characterized by recurrent episodes of airflow reduction or cessation due to a temporary reduction or absence of central respiratory drive. The fundamental hallmark of central sleep apnea (CSA) disorders is the presence of ventilatory control instability; however, additional mechanisms play a role in one or more specific manifestations of CSA. CSA may manifest during conditions of eucapnia/hypocapnia or chronic hypercapnia, which is a useful clinical classification that lends understanding to the underlying pathophysiology and potential therapies. In this review, an overview of normal breathing physiology is provided, followed by a discussion of pathophysiologic mechanisms that promote CSA and the mechanisms that are specific to different manifestations of CSA.
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, One Gustave Levy Place, Mount Sinai Hospital, 17 East 102 Street Floor 6th Floor Room West Tower, New York, NY, 10029, USA. abh1497@gmail.com.
authors.forename: Adam B
authors.initials: AB
authors.lastname: Hernandez
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Johns Hopkins Sleep Disorders Center, Johns Hopkins University School of Medicine, 5501 Hopkins Bayview Circle, Baltimore, MD, 21224, USA.
authors.forename: Susheel P
authors.initials: SP
authors.lastname: Patil
mesh_terms: D002639:Cheyne-Stokes Respiration / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D006935:Hypercapnia / Q000175:diagnosis / Q000503:physiopathology; D016857:Hypocapnia / Q000175:diagnosis / Q000503:physiopathology; D012123:Pulmonary Ventilation / Q000502:physiology; D012125:Respiratory Center / Q000503:physiopathology; D020182:Sleep Apnea, Central / Q000175:diagnosis / Q000503:physiopathology*
keywords: Central sleep apnea; Cheyne-Stokes breathing; Mechanisms; Pathophysiology