抽象的
普通人群中报告的睡眠障碍的患病率很高。许多抱怨是与睡眠有关的呼吸障碍的结果,这主要是由于阻塞性和中央呼吸暂停发生的。阻塞性睡眠呼吸暂停是一个充分描述且公认的实体。但是,中央睡眠呼吸暂停(CSA)的研究很差。有积极的证据表明应将中央睡眠呼吸暂停视为光谱的末端。呼吸模式中的不稳定性是主要的基础机制,是由于许多因素的相互作用。睡眠期间的呼吸取决于代谢控制和呼吸肌肉的活性。化学驱动和/或呼吸肌功能降低与CSA有关,通常在清醒期间持续不足衰减,其特征是慢性白天过度ca。上呼吸道反射也可以抑制中央呼吸驱动。然而,大多数情况下,CSA出现在睡眠期间不稳定的呼吸的标志,这是由于环路增益的总体增加(尤其是在轻度睡眠阶段)和透露二氧化碳阈值的掩盖。 Arousal following central apnoeas acts as an amplification of the instability. Micro electroencephographic (EEG) arousals are often observed as a consequence of CSA. They are responsible for sleep fragmentation and hypersomnolence during the day. The daytime hypersomnolence and complaints of awakenings during sleep in patients with CSA can be striking. CSA can occur in specific pathologies, such as chronic heart failure and (post-traumatic) brain lesions, that are associated with irregular breathing. Treatment strategies are remarkably few in number. Use of nasal ventilation and the inhalation of CO2 are mainly of theoretical interest, since patients do not often tolerate these more invasive therapies. Drug treatment, especially with acetazolamide, is easier to perform. Stimulation of upper airway reflexes, by less invasive methods, seems to be promising for the near future.