Central sleep apnoea syndrome with upper airway collapse.

We report on an 83 yr old man with hypersomnia and central sleep apnoea (CSA). He had several possible causes for CSA, including a central nervous system lesion, hypocapnia and anatomical narrowing of the airway at the hypopharyngeal level. We postulate that reduced central respiratory drive occurring in conjunction with upper airway narrowing may have led to central apnoeas. These in turn could have facilitated a complete passive hypopharyngeal collapse at the end of each apnoea, as visualized by somnofluoroscopy. The CSA could also have been favoured by respiratory instability due to chronic hypocapnia.

[1]  W. McNicholas,et al.  Clinical and physiologic heterogeneity of the central sleep apnea syndrome. , 2015, The American review of respiratory disease.

[2]  G. Ferretti,et al.  Somnofluoroscopy, computed tomography, and cephalometry in the assessment of the airway in obstructive sleep apnoea. , 1992, Thorax.

[3]  M. Kryger.  Sleep and heart failure. , 1990, The European respiratory journal.

[4]  M. Kryger,et al.  Respiration and abnormal sleep in patients with congestive heart failure. , 1989, Chest.

[5]  M. Niederman,et al.  Reversal of sleep apnea in uremia by dialysis. , 1987, Archives of internal medicine.

[6]  W. Mills,et al.  Respiratory stimulants and sleep periodic breathing at high altitude. Almitrine versus acetazolamide. , 1987, The American review of respiratory disease.

[7]  M Partinen,et al.  Central sleep apnea and partial obstruction of the upper airway , 1987, Annals of neurology.

[8]  N. Zamel,et al.  Differences in pharyngeal properties between snorers with predominantly central sleep apnea and those without sleep apnea. , 1987, The American review of respiratory disease.

[9]  C. Sullivan,et al.  Reversal of central sleep apnea using nasal CPAP. , 1986, Chest.

[10]  S. Chokroverty,et al.  Autonomic dysfunction and sleep apnea in olivopontocerebellar degeneration. , 1984, Archives of neurology.

[11]  B A Staats,et al.  Chest wall motion in sleep apnea. , 1984, The American review of respiratory disease.

[12]  C. Guilleminault,et al.  Cephalometric analyses and flow-volume loops in obstructive sleep apnea patients. , 1983, Sleep.

[13]  J A Dempsey,et al.  Interaction of sleep state and chemical stimuli in sustaining rhythmic ventilation. , 1983, Journal of applied physiology: respiratory, environmental and exercise physiology.

[14]  E. Wolpert.  A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects. , 1969 .

[15]  Allan I. Pack,et al.  Regulation of breathing , 1994 .

[16]  D. Flenley.  Regulation of Breathing Part II , 1983 .

[17]  M. Horsmanheimo,et al.  Lung biology in health and disease , 1977 .