Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- 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
Otros factores de diagnóstico
- ritmo cardíaco anormal ou presença da terceira ou quarta bulha cardíaca
- anormalidade focal no exame neurológico
- fraqueza neuromuscular
- história de endocrinopatia
Factores de riesgo
- 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
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- polissonografia noturna
Pruebas diagnósticas que deben considerarse
- hormônio estimulante da tireoide sérico
- creatinina sérica
- eletrocardiograma (ECG)
- concentração sérica de fator de crescimento semelhante à insulina-1 (teste de acromegalia)
- ecocardiograma
Algoritmo de tratamiento
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)
Colaboradores
Autores
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
Divulgaciones
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
Divulgaciones
LAT declares that she has no competing interests.
Agradecimientos
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.
Divulgaciones
JSA and TIM declare that they have no competing interests. CHW declares that she has been a speaker for Respironics CME.
Revisores por pares
Teofilo Lee-Chiong, MD
National Jewish Medical and Research Center
Denver
CO
Divulgaciones
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
Divulgaciones
JAF declares that he has no competing interests.
Referencias
Artículos principales
American Academy of Sleep Medicine. The AASM international classification of sleep disorders - third edition, text revision (ICSD-3-TR). Jun 2023 [internet publication].Texto completo
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.Texto completo Resumen
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.Texto completo Resumen
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.Texto completo Resumen
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.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Apneia obstrutiva do sono
- Síndromes de hipoventilação/hipoxemia relacionadas ao sono
- Depression
Más DiferencialesGuías de práctica clínica
- International classification of sleep disorders, 3rd edition, text revision (ICSD-3-TR)
- Sleep-disordered breathing and cardiac arrhythmias in adults: mechanistic insights and clinical implications: a scientific statement from the American Heart Association
Más Guías de práctica clínicaFolletos para el paciente
Apneia do sono em adultos (obstrutiva)
Más Folletos para el paciente
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