Disease relevance of Sleep Apnea, Central

• BACKGROUND: Theophylline has been used to treat central apnea associated with Cheyne-Stokes respiration (periodic breathing) [1].
• Although more controlled studies would be helpful, relatively clear-cut indications for the use of ventilatory stimulants exist for hypercapnic obesity-hypoventilation patients (medroxyprogesterone), myxedema (thyroid replacement), central apnea (acetazolamide), and periodic breathing in congestive heart failure (theophylline) [2].
• Patients with significant congestive heart failure, chronic obstructive pulmonary disease (COPD), or significant amounts of central apnea were excluded from many treatment trials and there is insufficient evidence that APAP can be used to treat these patients [3].
• Relationship between CO2 drive and characteristics of apneas in obstructive and central sleep apnea [4].
• A patient operated upon for a midline cerebellar hemangioblastoma developed failure of automatic respiration during sleep, together with central sleep apnea syndrome, approximately two years after receiving radiation therapy to the brain [5].

Psychiatry related information on Sleep Apnea, Central

• Ondansetron, a serotonin (5-HT) antagonist selective for the 5-HT3 receptor subtype has recently been shown to suppress sleep-related central apneas in rats, particularly in rapid-eye-movement (REM) sleep [6].
• In the others, central apneas with or without tachypnea and O2 desaturation were observed only during wakefulness [7].
• Effect of CO2 inhalation on central sleep apnea and arousals from sleep [8].

High impact information on Sleep Apnea, Central

• Loss of murine Na+/myo-inositol cotransporter leads to brain myo-inositol depletion and central apnea [9].
• Central sleep apnea and acetazolamide therapy [10].
• One night ASV suppresses central sleep apnea and/or CSR (CSA/CSR) in heart failure and improves sleep quality better than CPAP or 2 L/min oxygen [11].
• There were no significant differences in SRBD according to the stroke subtype except for the central apnea index (CAI) [12].
• We conclude that central apneas in patients with CHF are triggered by a low PaCO2 most likely sensed at the peripheral chemoreceptors, and that inhalation of CO2 reverses central apneas by raising PaCO2 [13].

Chemical compound and disease context of Sleep Apnea, Central

• Central sleep apnea. Improvement with acetazolamide therapy [14].
• We report the successful treatment of this patient's central sleep apnea syndrome with the use of supplemental CO2 therapy [15].
• Among the six patients who also inhaled O2, CO2 inhalation increased transcutaneous PCO2 (PtcCO2) (36.4 +/- 4.6 mm Hg versus 38 +/- 4.4 mm Hg, p < 0.002), abolished central apneas and hypopneas (43.0 +/- 8.4 per hour on air versus 1.6 +/- 2.6 per hour on CO2, p < 0.0001), and increased SaO2 [13].
• These data, if replicated, imply that benzodiazepine use may be beneficial in patients with central sleep apnea [16].
• Clonidine-induced central apneas were always associated with continuous tonic activation of the MPC [17].

Biological context of Sleep Apnea, Central

• Auditory middle-latency evoked potentials (AMEP) were recorded in 10 subjects with predominantly central sleep apnea [18].

Anatomical context of Sleep Apnea, Central

• The present findings may indicate a link between central nervous system dopamine activity and chronic central alveolar hypoventilation [19].

Gene context of Sleep Apnea, Central

• Effects of nasal CPAP on sympathetic activity in patients with heart failure and central sleep apnea [20].
• There was a corresponding progressive increase in central apnea length following the ventilatory period from no arousal (14.1 +/- 2.0) to EEG arousal (16.4 +/- 1.8) to movement arousal (18.1 +/- 2.0 s, p < 0.01) [21].
• RESULTS: Influence of ambient temperature was seen in: RESPIRATORY PARAMETERS: The frequency of central apneas increased significantly with increasing temperatures in REM sleep, but not in NREM sleep [22].
• Recordings were examined for occurrences of GER and for central apnea of 10 seconds or greater duration [23].
• These findings further suggest that endogenous 5-HT, acting at least at peripheral 5-HT3 receptors, may play a baseline physiologic role in the expression of spontaneous central apneas in rats [24].

Analytical, diagnostic and therapeutic context of Sleep Apnea, Central

• Intraperitoneal injection of 5-HT (0.79 mg/kg) to rats increased spontaneous central apneas during rapid eye movement (REM) sleep by > 250% in comparison to control recording (p = 0.01) [24].
• Patients were divided into a CSR-CSA group (n = 12, mean +/- SEM of 49.2 +/- 6.3 central apneas and hypopneas per h sleep) and a control group without CSR-CSA (n = 12, 4.9 +/- 0.8 central apneas and hypopneas per h sleep) [25].

References