中枢性睡眠呼吸暂停低通气综合征的研究进展
Research Progress of Central Sleep Apnea Hypopnea Syndrome
DOI: 10.12677/ACM.2023.1392107, PDF,   
作者: 刘雅娟:青海大学研究生院,青海 西宁;郝丽娟*:青海红十字医院耳鼻喉科,青海 西宁
关键词: 中枢性睡眠呼吸暂停低通气综合征无创正压通气Central Sleep Apnea Hypopnea Syndrome Noninvasive Positive Pressure Ventilation
摘要: 中枢性睡眠呼吸暂停低通气(CSA)是睡眠呼吸障碍的一种,主要以异常通气驱动引起的间歇性呼吸减弱或停止,同时伴胸腹运动消失。患者可出现困倦、频繁的气促觉醒、打鼾等症状,可导致全身多系统功能障碍及代谢的异常,严重者可威胁生命。本文系统性地回顾了国内外相关文献,主要对CSA的基本特征及治疗进展进行综述,为将来CSA的诊断、治疗提供新思路。
Abstract: Central sleep apnea hypopnea (CSA) is a type of sleep breathing disorder, mainly caused by abnor-mal ventilatory drive, intermittent decreased or stopped breathing, accompanied by the loss of chest and abdominal movements. Patients may have drowsiness, frequent shortness of breath and awakening, snoring and other symptoms, which can lead to systemic multi-system dysfunction and metabolic abnormalities, and even threaten life in severe cases. By systematically reviewing the relevant literature at home and abroad, this article mainly reviews the basic characteristics and treatment progress of CSA, so as to provide new ideas for the diagnosis and treatment of CSA in the future.
文章引用:刘雅娟, 郝丽娟. 中枢性睡眠呼吸暂停低通气综合征的研究进展[J]. 临床医学进展, 2023, 13(9): 15066-15073. https://doi.org/10.12677/ACM.2023.1392107

参考文献

[1] Ishikawa, O. and Oks, M. (2021) Central Sleep Apnea. Clinics in Geriatric Medicine, 37, 469-481. [Google Scholar] [CrossRef] [PubMed]
[2] Baillieul, S., Revol, B., Jullian-Desayes, I., Joyeux-Faure, M., Tamisier, R. and Pépin, J.L. (2019) Diagnosis and Management of Central Sleep Apnea Syndrome. Expert Review of Respiratory Medicine, 13, 545-557. [Google Scholar] [CrossRef] [PubMed]
[3] Roberts, E.G., Raphelson, J.R., Orr, J.E., LaBuzetta, J.N. and Malhotra, A. (2022) The Pathogenesis of Central and Complex Sleep Apnea. Current Neurology and Neuroscience Reports, 22, 405-412. [Google Scholar] [CrossRef] [PubMed]
[4] Lévy, P., Naughton, M.T., Tamisier, R., Cowie, M.R. and Brad-ley, T.D. (2022) Sleep Apnoea and Heart Failure. European Respiratory Journal, 59, Article 2101640. [Google Scholar] [CrossRef] [PubMed]
[5] Nakamura, S., Asai, K., Kubota, Y., et al. (2015) Impact of Sleep-Disordered Breathing and Efficacy of Positive Airway Pressure on Mortality in Patients with Chronic Heart Failure and Sleep-Disordered Breathing: A Meta-Analysis. Clinical Research in Cardiology, 104, 208-216. [Google Scholar] [CrossRef] [PubMed]
[6] Hernandez, A.B. and Patil, S.P. (2016) Pathophysiology of Cen-tral Sleep Apneas. Sleep and Breathing, 20, 467-482. [Google Scholar] [CrossRef] [PubMed]
[7] Sateia, M.J. (2014) International Classification of Sleep Disor-ders-Third Edition: Highlights and Modifications. CHEST, 146, 1387-1394. [Google Scholar] [CrossRef] [PubMed]
[8] Ginter, G. and Badr, M.S. (2022) Central Sleep Apnea. Handbook of Clinical Neurology, 189, 93-103. [Google Scholar] [CrossRef
[9] 苗志斌, 王耶盈, 孙睿, 雷红丽, 黄代金, 黄李华, 樊重阳, 吕云辉. 高原地区OSAS患者CPAP治疗后中枢性睡眠呼吸暂停的发生率及影响因素[J]. 中华医学杂志, 2017, 97(12): 915-919.
[10] Watanabe, N., Levri, J.M., Peng, V.T., Scharf, S.M. and Diaz-Abad, M. (2022) Av-erage Volume-Assured Pressure Support for Patients with Obstructive Sleep Apnea with Failed CPAP Titration. Sleep Science, 15, 328-332. [Google Scholar] [CrossRef] [PubMed]
[11] Muza, R.T. (2015) Central Sleep Apnoea—A Clinical Review. Journal of Thoracic Disease, 7, 930-937.
[12] Kouri, I., Kolla, B.P., Morgenthaler, T.I. and Mansukhani, M.P. (2020) Frequency and Outcomes of Primary Central Sleep Apnea in a Population-Based Study. Sleep Medicine, 68, 177-183. [Google Scholar] [CrossRef] [PubMed]
[13] Lombardi, C., Meriggi, P., Agostoni, P., et al. (2013) High-Altitude Hypoxia and Periodic Breathing during Sleep: Gender-Related Differences. Journal of Sleep Research, 22, 322-330. [Google Scholar] [CrossRef] [PubMed]
[14] Tan, L., Li, T., Luo, L., et al. (2022) The Characteristics of Sleep Apnea in Tibetans and Han Long-Term High Altitude Residents. Nature and Science of Sleep, 14, 1533-1544. [Google Scholar] [CrossRef
[15] Bloch, K.E., Latshang, T.D. and Ulrich, S. (2015) Patients with Ob-structive Sleep Apnea at Altitude. High Altitude Medicine & Biology, 16, 110-116. [Google Scholar] [CrossRef] [PubMed]
[16] Pham, L.V., Meinzen, C., Arias, R.S., et al. (2017) Cross-Sectional Comparison of Sleep-Disordered Breathing in Native Peruvian Highlanders and Lowlanders. High Altitude Medicine & Biology, 18, 11-19. [Google Scholar] [CrossRef] [PubMed]
[17] Randerath, W., Verbraecken, J., Andreas, S., et al. (2017) Definition, Discrimination, Diagnosis and Treatment of Central Breathing Disturbances during Sleep. European Respiratory Jour-nal, 49, Article ID: 1600959. [Google Scholar] [CrossRef] [PubMed]
[18] Bird, J.D., Kalker, A., Rimke, A.N., et al. (2021) Severity of Central Sleep Apnea Does Not Affect Sleeping Oxygen Saturation during Ascent to High Altitude. Journal of Applied Physiology, 131, 1432-1443. [Google Scholar] [CrossRef] [PubMed]
[19] Liu, H.-M., Chiang, I.-J., Kuo, K.-N., Liou, C.-M. and Chen, C. (2017) The Effect of Acetazolamide on Sleep Apnea at High Altitude: A Systematic Review and Meta-Analysis. Therapeutic Advances in Respiratory Disease, 11, 20-29. [Google Scholar] [CrossRef] [PubMed]
[20] Freire, C., Sennes, L.U. and Polotsky, V.Y. (2022) Opioids and Obstructive Sleep Apnea. Journal of Clinical Sleep Medicine, 18, 647-652. [Google Scholar] [CrossRef] [PubMed]
[21] Zheng, C.R., Chen, G.Z., Yu, J., et al. (2014) Inhaled Budesonide and Oral Dexamethasone Prevent Acute Mountain Sickness. The American Journal of Medicine, 127, 1001-1009. [Google Scholar] [CrossRef] [PubMed]
[22] Rocha, A., Pinto, A.C.P.N., Pachito, D.V., Drager, L.F., Lo-renzi-Filho, G. and Atallah, Á.N. (2023) Pharmacological Treatment for Central Sleep Apnoea in Adults. Cochrane Da-tabase of Systematic Reviews, 2, CD012922. [Google Scholar] [CrossRef
[23] Schmickl, C.N., Landry, S.A., Orr, J.E., et al. (2020) Acetazolamide for OSA and Central Sleep Apnea: A Comprehensive Systematic Review and Meta-Analysis. Chest, 158, 2632-2645. [Google Scholar] [CrossRef] [PubMed]
[24] 中华医学会呼吸病学分会睡眠呼吸障碍学组. 睡眠呼吸疾病无创正压通气临床应用专家共识(草案) [J]. 中华结核和呼吸杂志, 2017, 40(9): 667-677. [Google Scholar] [CrossRef
[25] Nicolini, A., Banfi, P., Grecchi, B., et al. (2014) Non-Invasive Ventilation in the Treatment of Sleep-Related Breathing Disorders: A Review and Update. Revista Portu-guesa de Pneumologia, 20, 324-335. [Google Scholar] [CrossRef] [PubMed]
[26] Liao, W.-J., Song, L.-J., Yi, H.-L., et al. (2018) Treatment Choice by Patients with Obstructive Sleep Apnea: Data from Two Centers in China. Journal of Thoracic Disease, 10, 1941-1950. [Google Scholar] [CrossRef] [PubMed]
[27] Johnson, K.G. and Johnson, D.C. (2015) Treatment of Sleep-Disordered Breathing with Positive Airway Pressure Devices: Technology Update. Medical Devices: Evidence and Research, 8, 425-437. [Google Scholar] [CrossRef
[28] Harper, R.M., Kumar, R., Ogren, J.A. and Macey, P.M. (2013) Sleep-Disordered Breathing: Effects on Brain Structure and Function. Respiratory Physiology & Neurobiology, 188, 383-391. [Google Scholar] [CrossRef] [PubMed]
[29] Dalmases, M., Solé-Padullés, C., Torres, M., et al. (2015) Effect of CPAP on Cognition, Brain Function, and Structure among Elderly Patients with OSA: A Randomized Pilot Study. CHEST, 148, 1214-1223. [Google Scholar] [CrossRef] [PubMed]
[30] 张成, 马靖, 陈坤, 陈雪, 王广发, 张珏. 持续正压通气对原发性中枢性睡眠呼吸暂停综合征患者睡眠脑电的影响[J]. 中国医学前沿杂志(电子版), 2018, 10(9): 75-79.
[31] Montesi, S.B., Edwards, B.A., Malhotra, A. and Bakker, J.P. (2012) The Effect of Continuous Positive Airway Pressure Treat-ment on Blood Pressure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of Clinical Sleep Medicine, 8, 587-596. [Google Scholar] [CrossRef] [PubMed]
[32] Goudis, C.A. and Ketikoglou, D.G. (2017) Obstructive Sleep and Atrial Fibrillation: Pathophysiological Mechanisms and Therapeutic Implications. International Journal of Cardiology, 230, 293-300. [Google Scholar] [CrossRef] [PubMed]
[33] Bradley, T.D., Logan, A.G., Kimoff, R.J., et al. (2005) Continu-ous Positive Airway Pressure for Central Sleep Apnea and Heart Failure. The New England Journal of Medicine, 353, 2025-2033. [Google Scholar] [CrossRef
[34] Stoltzfus, S. (2006) The Role of Noninvasive Ventilation: CPAP and BiPAP in the Treatment of Congestive Heart Failure. Dimensions of Critical Care Nursing, 25, 66-70. [Google Scholar] [CrossRef] [PubMed]
[35] Arzt, M., Wensel, R., Montalvan, S., et al. (2008) Ef-fects of Dynamic Bilevel Positive Airway Pressure Support on Central Sleep Apnea in Men with Heart Failure. CHEST, 134, 61-66. [Google Scholar] [CrossRef] [PubMed]
[36] Khattak, H.K., Hayat, F., Pamboukian, S.V., Hahn, H.S., Schwartz, B.P. and Stein, P.K. (2018) Obstructive Sleep Apnea in Heart Failure: Review of Prevalence, Treatment with Continuous Positive Airway Pressure, and Prognosis. Texas Heart Institute Journal, 45, 151-161. [Google Scholar] [CrossRef
[37] 李庆云. 国外睡眠呼吸疾病家庭无创正压通气治疗指南及专家共识概述[J]. 中华结核和呼吸杂志, 2017, 40(9): 660-662.
[38] 韩芳. 加强无创正压通气技术在中国睡眠呼吸障碍患者治疗中的应用[J]. 中华医学杂志, 2015, 95(16): 1201-1202.
[39] Wu, X., Fu, C., Zhang, S., Liu, Z., Li, S. and Jiang, L. (2017) Adaptive Servoventilation Improves Cardiac Dysfunction and Prognosis in Heart Failure Patients with Sleep-Disordered Breathing: A Meta-Analysis. The Clinical Respiratory Journal, 11, 547-557. [Google Scholar] [CrossRef] [PubMed]
[40] Chen, C., Wen, T. and Liao, W. (2019) Nocturnal Supports for Patients with Central Sleep Apnea and Heart Failure: A Systemic Review and Network Meta-Analysis of Randomized Controlled Tri-als. Annals of Translational Medicine, 7, 337. [Google Scholar] [CrossRef] [PubMed]
[41] 虎盘林, 赵海平, 董剑宏. 适应性支持通气模式在颈髓损伤后呼吸衰竭患者中的应用[J]. 临床和实验医学杂志, 2019, 18(12): 1312-1314.
[42] Piccini, J.P., Pokorney, S.D., Anstrom, K.J., et al. (2019) Adaptive Servo-Ventilation Reduces Atrial Fibrillation Burden in Patients with Heart Failure and Sleep Apnea. Heart Rhythm, 16, 91-97. [Google Scholar] [CrossRef] [PubMed]
[43] Bordier, P., Orazio, S., Hofmann, P., Robert, F. and Bourenane, G. (2015) Short- and Long-Term Effects of Nocturnal Oxygen Therapy on Sleep Apnea in Chronic Heart Failure. Sleep and Breathing, 19, 159-168. [Google Scholar] [CrossRef] [PubMed]
[44] 黄金莎, 王涛. 中枢性睡眠呼吸暂停治疗方法进展[J]. 中华神经科杂志, 2017, 50(1): 74-78.
[45] Mulchrone, A., Shokoueinejad, M. and Webster, J. (2016) A Review of Pre-venting Central Sleep Apnea by Inspired CO2. Physiological Measurement, 37, R36-R45. [Google Scholar] [CrossRef
[46] Xie, A., Teodorescu, M., Pegelow, D.F., et al. (2013) Effects of Stabilizing or Increasing Respiratory Motor Outputs on Obstructive Sleep Apnea. Journal of Applied Physiology, 115, 22-33. [Google Scholar] [CrossRef] [PubMed]
[47] Pinto, A.C.P.N., Rocha, A., Pachito, D.V., Drager, L.F. and Lorenzi-Filho, G. (2022) Non-Invasive Positive Pressure Ventilation for Central Sleep Apnoea in Adults. Cochrane Da-tabase of Systematic Reviews, 10, CD012889. [Google Scholar] [CrossRef
[48] Zhang, X., Ding, N., Ni, B., Yang, B., Wang, H. and Zhang, S.-J. (2017) Safety and Feasibility of Chronic Transvenous Phrenic Nerve Stimulation for Treatment of Central Sleep Apnea in Heart Failure Patients. The Clinical Respiratory Journal, 11, 176-184. [Google Scholar] [CrossRef] [PubMed]
[49] Sagalow, E.S., Ananth, A., Alapati, R., Fares, E. and Fast, Z. (2022) Trans-venous Phrenic Nerve Stimulation for Central Sleep Apnea. The American Journal of Cardiology, 180, 155-162. [Google Scholar] [CrossRef] [PubMed]
[50] Berbenetz, N., Wang, Y., Brown, J., et al. (2019) Non-Invasive Positive Pressure Ventilation (CPAP or Bilevel NPPV) for Cardiogenic Pulmonary Oedema. Cochrane Database of Systematic Reviews, No. 4, CD005351. [Google Scholar] [CrossRef