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Children with Prader Willi Syndrome (PWS) have several sleep abnormalities, including reduced REM sleep, altered sleep structure, oxygen desaturation and both central and obstructive apnea.
Apnea events that included both central and obstructive components were scored as a mixed apnea.
If both central and obstructive events were observed, OSA or CSA was diagnosed according to the prevalence of either event (>50% of the events).
Sleep apnea can be classified as central if there is no effort or airflow (central apnea has a <1% frequency of all apnea), obstructive if the respiratory effort is preserved and increased in the presence of partial or complete occlusion on the upper airway, and mixed if there is a combination of both central and obstructive apnea.
One study showed a beneficial effect of atrial pacing at a rate 15 beats faster than the mean nocturnal heart rate resulting in a reduction in the number of both central and obstructive apnoeas [ 42], although subsequent studies failed to confirm these correlations.
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This sequence explains the overlap between central and obstructive apnea (upper airway obstruction often follows central apneas upon resumption of respiratory effort, i.e., mixed apnea).
The WADD also had the added feature of being able to differentiate between central and obstructive apnoea.
Further on, detection of SRBD using screening methods might be associated with bias in calculation of the severity of SRBD and differentiation between central and obstructive forms.
Cheyne-Stokes breathing with central and obstructive apnea in the context of severe cardiac insufficiency has been shown to negatively influence the clinical situation and survival [ 46].
Heart failure may lead to hypoperfusion and hypooxygenation of tissues and this is often exacerbated by central and obstructive sleep apnoeas associated with recurrent episodes of systemic hypoxia which triggers release of ATP within the CNS circuits controlling sympathetic outflow.
The polygraphs used in this study did not provide a channel to measure thoracic wall motion, and thus an unequivocal differentiation between central and obstructive apnea/hypopnea was not possible.
More suggestions(13)
both annoying and obstructive
both central and regional
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both central and stable
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both restrictive and obstructive
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Justyna Jupowicz-Kozak
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