The pathophysiology behind central sleep apnoea (CSA) is complex, due to the intricate mechanisms that regulate breathing during sleep. So we asked sleep medicine expert Dr Elisa Perger to help simplify things, with two videos designed to enhance your clinical knowledge and understanding.
Dr Perger begins by going back to basics, by explaining what CSA is, its classifications, causes and how it differs to obstructive sleep apnoea – including how to distinguish between central and obstructive events when looking at polysomnography results – before discussing the pathophysiology in more detail, including:
- An explanation of the two main types of the condition: CSA associated with hypoventilation and CSA associated with normo-hyperventilation
- Why it is important to check patients’ blood gas to determine whether they have hypocapnia or hypercapnia
- How normal breathing is controlled during sleep and the role of chemoreceptors
- What loop gain is and how it explains the stability of the ventilatory system, with a view on different central breathing disturbances during sleep.
Interested in how CO2 reserve and loop gain can determine specific CSA syndromes? This is covered in our second video – where Dr Perger takes a closer look at three practical examples:
- Cheyne-Stokes respiration
- Opioid treatment
- Treatment-emergent central sleep aponea (TESCA)
Dr Perger concludes by emphasising the importance of phenotyping and understanding the cause of CSA in each patient to help develop new treatments using precision medicine.
