Central apnea

Introduction Central sleep apnea syndrome (CSAS) refers to the absence of airflow in the upper airway for more than 10 s without chest and abdomen breathing. CSAS is less common and can coexist with obstructive sleep apnea syndrome (OSAS). It can occur in any sleep phase, but obvious abnormalities are only seen in slow phase sleep (NREM, also known as normal phase sleep and slow wave sleep). CSAS can exist alone or in conjunction with central nervous system diseases such as brain stem trauma, tumors, infarctions, and infections. There have also been reports of CSAS associated with neuromuscular disorders such as polio and myotonic dystrophy. Appropriate ventilation can be maintained when awake, but during sleep, there is an abnormal regulation of the respiratory center, and a central (or obstructive) apnea occurs.

Cause

The simple central apnea is rarely more than 10%. He is actually the main reason for the central dysfunction of the brain. Central apnea is mainly caused by diseases of the nervous system, such as spinal cord disease, encephalitis, occipital macropore developmental malformation, and central apnea familial autonomic abnormalities. It also includes some muscle lesions, such as diaphragmatic muscles, myotonic dystrophy, and myopathy. And some apnea caused by heart failure.

an examination

Related inspection

Respiratory exercise test

The indication for polysomnography is that the patient's respiratory disorder index (RDI) is at least 20 times per hour, regardless of symptoms; or the AHI/RDI ratio is 10 times per hour with extreme daytime sleepiness. Once obstructive sleep apnea (OSA) is diagnosed, the patient will return to the study the night after. In the meantime, doctors will use continuous positive airway pressure (CPAP) or bi-level positive airway pressure (BiPAP) to adjust the polysomnogram to a certain level in order to eliminate or significantly reduce the number of respiratory abnormalities.

Differential diagnosis

Differential diagnosis of central apnea:

1, obstructive sleep apnea syndrome: more than the upper respiratory tract, especially the nasal, central apnea pharyngeal stenosis pathological basis, such as obesity, allergic rhinitis, nasal polyps, tonsil hypertrophy, soft palate relaxation, excessive drooping Too thick, hypertrophy of the tongue, fall of the tongue, mandibular retraction, temporomandibular joint dysfunction and small jaw deformity. His pathogenesis is actually the lack of airway. It can be understood that the obstructiveness is mainly due to the unobstructed airway. The centrality is that the airway is unobstructed, and it may be mixed.

2, lack of deep sleep: deep sleep deficiency is common in obstructive sleep apnea syndrome. During deep sleep, human cerebral cortical cells are in a state of full rest, which is extremely important for stabilizing mood, balancing mentality, and restoring energy. At the same time, many antibodies can be produced in the human body to enhance disease resistance. Studies have shown that the first three hours of sleep are important because deep sleep accounts for almost 90% of the time.

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