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A Journal on Diseases of the Respiratory System
Official Journal of the Italian Society of Thoracic Endoscopy
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
REVIEWS SLEEP DISORDERS
Minerva Pneumologica 2011 September;50(3):217-36
Current management of sleep-related breathing disorders
Patel S. R., Dhand R.
Division of Pulmonary, Critical Care and Environmental Medicine, Department of Medicine, University of Missouri, Columbia, MO, USA
Breathing disorders occur very commonly during sleep, limit the ability to fall into deep sleep, lead to daytime somnolence, and are associated with several comorbid conditions. Sleep-related breathing disorders are classified into 3 categories, namely 1) obstructive sleep apnea; 2) central sleep apnea; and 3) central hypoventilation syndromes. Although these entities are described as discrete disorders there is significant overlap between them. This article reviews the current management of sleep-related breathing disorders. Noninvasive positive pressure ventilation remains the cornerstone of treatment for sleep-related breathing disorders, and regular use of positive airway pressure has enormous benefits for patients with sleep apnea. Adjunctive therapies include behavioral modification such as weight loss, supplemental oxygen, oral appliances, surgical techniques, respiratory stimulants, and measures to optimize cardiac function, among others. A multidisciplinary approach to management which includes patient education, smoking cessation, behavioral modification, and treatment of comorbidities is highly recommended. In addition, individual attention to various occupational and social factors, the positive airway pressure requirement, a well-fitting interface that is acceptable to the patient, monitoring adherence to the treatment regimen, frequent communication and patient education, and regular follow-up are required to optimize outcomes in patients with sleep-related breathing disorders.