Treatment of sleep related breathing disorders in patients with cardiovascular system diseases

Česká verzia

Authors: MUDr. Pavel Matuška, Ph.D.; Fccp ¹; doc. MUDr. Tomáš Kára; Ph.D. ^1,2; MUDr. Pavel Homolka; Ph.D. ^1,3; Ing. Miloš Bělehrad ¹; MUDr. Ondřej Ludka; Ph.D. ^1,4; Prof. MUDr. Miroslav Souček, CSc. ^1,5
Authors place of work: Mezinárodní centrum klinického výzkumu – Kardiovaskulární spánkové výzkumné centrum LF MU a FN u sv. Anny v Brně ¹; Mezinárodní centrum klinického výzkumu – I. interní kardioangiologická klinika LF MU a FN u sv. Anny v Brně ²; Klinika tělovýchovného lékařství a rehabilitace LF MU a FN u sv. Anny v Brně ³; Interní kardiologická klinika LF MU a FN Brno ⁴; II. interní klinika LF MU a FN u sv. Anny v Brně kara. tomas@mayo. edu ⁵
Published in the journal: Kardiol Rev Int Med 2013, 15(2): 94-98
Category:

Summary

Sleep related breathing disorders are divided into two basic types:
obstructive sleep apnoea and central sleep apnoea. A specific form is a so- called mixed sleep apnoea. Sleep related obstructive breathing disorders are caused by the narrowing or collapse of the upper airway and cause snoring syndrome, increased upper airway resistance syndrome and obstructive sleep apnoea. Pathophysiology of central sleep apnoea is complex; in hemodynamically contingent forms of central sleep apnoea (heart failure) there is an increase in pulmonary wedge blood pressure and a change of chemoreflex sensitivity. In the treatment of obstructive sleep apnoea, the first choice of treatment is permanent positive airway pressure with the BiPAP. In case of intolerance, other options such as orthodontic or surgical treatment can be used. In the treatment of central sleep apnoea, the fundamental principle is maximal pharmacological and regimen treatment for prevention of heart failure, combined with adaptive servoventilation. Other possibilities include cardiac resynchronization therapy, controlled rehabilitation, and oxygen inhalation therapy. However, in many patients with severe forms of heart failure, central sleep apnoea disappears after cardiac transplantation or the introduction of mechanical cardiac support. This article summarises the basic principles of treatment of both types of sleep related breathing disorders.

Keywords:
sleep related breathing disorders – obstructive sleep apnoea – central sleep apnoea – therapy

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