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sleep-related hypoventilation syndrome
Etiology:
- chronic obstructive pulmonary disease (COPD)
- obesity hypoventilation syndrome
- myxedema
- neuromuscular disease
- muscular dystrophy
- amyotrophic lateral sclerosis
- myasthenia gravis
- Guillain-Barre syndrome
- phrenic nerve injury
- poliomyelitis, post-polio syndrome
- cervical spine injury
- kyphoscoliosis
Pathology:
- impaired gas exchange while awake, further compromised by sleep
Management:
- treat underlying disorder
- positive pressure ventilation
- BiPAP with or without supplemental oxygen preferred vs CPAP [1]
- mechanical ventilation may be needed for severe/end-stage neuromuscular disease
- oxygen without ventilatory assistance may further decrease ventilation in patients with neuromuscular disease [1]
Specific
obesity hypoventilation syndrome
General
hypoventilation
sleep disorder
syndrome
References
- Medical Knowledge Self Assessment Program (MKSAP) 17, 18, 19.
American College of Physicians, Philadelphia 2015, 2018, 2022