Sleep and Breathing

, Volume 20, Issue 2, pp 467–482 | Cite as

Pathophysiology of central sleep apneas

Sleep Breathing Physiology and Disorders • Review


The transition from wake to sleep is accompanied by a host of physiologic changes, which result in major alterations in respiratory control and may result in sleep-related breathing disorders. The central sleep apneas are a group of sleep-related breathing disorders that are characterized by recurrent episodes of airflow reduction or cessation due to a temporary reduction or absence of central respiratory drive. The fundamental hallmark of central sleep apnea (CSA) disorders is the presence of ventilatory control instability; however, additional mechanisms play a role in one or more specific manifestations of CSA. CSA may manifest during conditions of eucapnia/hypocapnia or chronic hypercapnia, which is a useful clinical classification that lends understanding to the underlying pathophysiology and potential therapies. In this review, an overview of normal breathing physiology is provided, followed by a discussion of pathophysiologic mechanisms that promote CSA and the mechanisms that are specific to different manifestations of CSA.


Central sleep apnea Pathophysiology Mechanisms Cheyne-Stokes breathing 


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Division of Pulmonary, Critical Care and Sleep Medicine, One Gustave Levy PlaceMount Sinai HospitalNew YorkUSA
  2. 2.Division of Pulmonary and Critical Care Medicine, Johns Hopkins Sleep Disorders CenterJohns Hopkins University School of MedicineBaltimoreUSA

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