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Apneia central do sono

  • Visão geral
  • Teoria
  • Diagnóstico
  • Tratamento
  • ACOMPANHAMENTO
  • Recursos
Last reviewed: 9 Apr 2025
Last updated: 24 Dec 2024

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • insônia, especialmente insônia de manutenção do sono
  • baixa concentração e falta de atenção
  • respiração periódica ou cessação da respiração ou ronco durante o sono observada (pelo parceiro)
  • dispneia transitória que desperta do sono ou impede o início do sono
  • cefaleias ao acordar
  • queixas de sono pouco restaurador e/ou sonolência diurna
  • respiração periódica durante a vigília
Full details

Other diagnostic factors

  • ritmo cardíaco anormal ou presença da terceira ou quarta bulha cardíaca
  • anormalidade focal no exame neurológico
  • fraqueza neuromuscular
  • história de endocrinopatia
Full details

Risk factors

  • insuficiência cardíaca congestiva
  • acidente vascular cerebral (AVC)
  • insuficiência renal
  • sexo masculino
  • fibrilação atrial
  • idade ≥60 anos
  • uso de opioides
  • lesões do tronco encefálico
  • fraqueza neuromuscular
  • acromegalia
  • hipotireoidismo
Full details

Diagnostic tests

1st tests to order

  • polissonografia noturna
Full details

Tests to consider

  • hormônio estimulante da tireoide sérico
  • creatinina sérica
  • eletrocardiograma (ECG)
  • concentração sérica de fator de crescimento semelhante à insulina-1 (teste de acromegalia)
  • ecocardiograma
Full details

Treatment algorithm

ACUTE

sem padrão de respiração de Cheyne-Stokes: em decorrência de afecção clínica

sem padrão de respiração de Cheyne-Stokes: primária (idiopática)

com respiração de Cheyne-Stokes

decorrente de respiração periódica da alta altitude

decorrente de uso indevido de medicamento ou substância

tratamento de emergência para apneia central do sono (ACS)

Contributors

Authors

Bernardo J. Selim, MD

Associate Professor of Medicine

Director of Respiratory Care Unit

Division of Pulmonary, Critical Care, and Sleep Medicine

Mayo Clinic

Rochester

MN

Disclosures

BJS declares that he has no competing interests.

Lauren A. Tobias, MD

Assistant Professor of Medicine

Yale University School of Medicine

Department of Internal Medicine

Section of Pulmonary, Critical Care and Sleep Medicine

New Haven

CT

Disclosures

LAT declares that she has no competing interests.

Acknowledgements

Dr Bernardo J. Selim and Dr Lauren A. Tobias would like to gratefully acknowledge Dr J. Shirine Allam, Dr Timothy I. Morgenthaler, and Dr Christine H. Won, previous contributors to this topic.

Disclosures

JSA and TIM declare that they have no competing interests. CHW declares that she has been a speaker for Respironics CME.

Peer reviewers

Teofilo Lee-Chiong, MD

National Jewish Medical and Research Center

Denver

CO

Disclosures

TLC has been reimbursed by the American College of Chest Physicians (ACCP), American Academy of Sleep Medicine, American Thoracic Society, and Cephalon, the manufacturer of modafinil, for attending several conferences. He has been paid by the ACCP for running educational programs and by Elsevier for serving as consultant of the Sleep Medicine Clinics. He has also received research funding from the National Institutes of Health, Respironics, Restore, and Schwarz Pharma, and has been a member of the speakers' bureau for GlaxoSmithKline.

John A. Fleetham, MD, FRCP

Professor

University of British Columbia

Vancouver

Canada

Disclosures

JAF declares that he has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

American Academy of Sleep Medicine. The AASM international classification of sleep disorders - third edition, text revision (ICSD-3-TR). Jun 2023 [internet publication].Full text

Randerath W, Verbraecken J, Andreas S, et al. Definition, discrimination, diagnosis and treatment of central breathing disturbances during sleep. Eur Respir J. 2017 Jan;49(1):1600959.Full text  Abstract

Mayer G, Arzt M, Braumann B, et al. German S3 guideline nonrestorative sleep/sleep disorders, chapter "sleep-related breathing disorders in adults," short version: German Sleep Society (Deutsche Gesellschaft für Schlafforschung und Schlafmedizin, DGSM). Somnologie (Berl). 2017;21(4):290-301.Full text  Abstract

Aurora RN, Bista SR, Casey KR, et al. Updated adaptive servo-ventilation recommendations for the 2012 AASM guideline: "The treatment of central sleep apnea syndromes in adults: practice parameters with an evidence-based literature review and meta-analyses". J Clin Sleep Med. 2016 May 15;12(5):757-61.Full text  Abstract

Aurora RN, Chowdhuri S, Ramar K, et al. The treatment of central sleep apnea syndromes in adults: practice parameters with an evidence-based literature review and meta-analyses. Sleep. 2012 Jan 1;35(1):17-40.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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