Sleep-Related Breathing Disorders: When CPAP Is Not Enough

Selim, Bernardo J.; Ramar, Kannan

doi:10.1007/s13311-020-00955-x

Cited by 16 publications

(11 citation statements)

References 55 publications

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“…45 mmHg). 56 Primary central sleep apnea, nocturnal hypoventilation associated with neuromuscular disease or underlying lung disease often present with elevated paCO 2 . 56 Meanwhile, treatment-emergent apnea, central sleep apnea associated with heart failure or high altitude, and central apnea associated medication and substance use may present with normal paCO2 levels.…”

Section: Indications For Nivmentioning

confidence: 99%

“…56 Primary central sleep apnea, nocturnal hypoventilation associated with neuromuscular disease or underlying lung disease often present with elevated paCO 2 . 56 Meanwhile, treatment-emergent apnea, central sleep apnea associated with heart failure or high altitude, and central apnea associated medication and substance use may present with normal paCO2 levels. 56 First line treatment for management of central sleep apnea related to heart failure and medication or substance use to optimize the underlying medical condition and discontinue the offending agent if feasible, respectively.…”

Section: Indications For Nivmentioning

confidence: 99%

“…56 Meanwhile, treatment-emergent apnea, central sleep apnea associated with heart failure or high altitude, and central apnea associated medication and substance use may present with normal paCO2 levels. 56 First line treatment for management of central sleep apnea related to heart failure and medication or substance use to optimize the underlying medical condition and discontinue the offending agent if feasible, respectively. 57 If despite the intervention, central or complex sleep apnea continues, different types NIV can be utilized depending on the underlying condition.…”

Section: Indications For Nivmentioning

confidence: 99%

“…57 If despite the intervention, central or complex sleep apnea continues, different types NIV can be utilized depending on the underlying condition. 56 Obesity hypoventilation syndrome (OHS) is another well-known indication for NIV use. OHS is defined by hypoventilation during wakefulness (paCO 2 > 45 mmHg), presence of obesity (BMI > 30 kg/m 2 ), and absence of other conditions that may lead to hypoventilation such as underlying lung disease, pulmonary vascular disease, chest wall disorder, medication use, neuromuscular disease, congenital or idiopathic central alveolar hypoventilation syndrome.…”

Section: Indications For Nivmentioning

confidence: 99%

“…However, those without concomitant OSA and primarily nocturnal hypoventilation, defined by PaCO2 > 55 mmHg for >10 minutes or an increase in PaCO 2 > 10 mmHg when awake PaCO2 > 50 mmHg for > 10 minutes, may require treatment with NIV. 56 In addition, neuromuscular diseases such as amyotrophic lateral sclerosis (ALS), muscular dystrophies, myopathies, and spinal muscular atrophies are also indications for the use of NIV. In fact, use of NIV in ALS patients have demonstrated survival advantage.…”

Section: Indications For Nivmentioning

confidence: 99%

See 4 more Smart Citations

An Overview of Noninvasive Ventilation in Cystic Fibrosis

Jobanputra

Jagpal

Marulanda

et al. 2021

Preprint

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Noninvasive ventilation (NIV) use was initially reported in cystic fibrosis (CF) in 1991 as a bridge to lung transplantation, and over the decades the use of NIV has increased in the CF population. Individuals with CF are prone to various physiologic changes as lung function worsens, and they may benefit from NIV for advanced lung disease. As life expectancy in CF has been increasing due to advances such as highly effective modulator therapy, people with CF are now subject to the same co-morbidities that may benefit from NIV as their age matched cohorts. NIV can improve gas exchange, quality of sleep, exercise tolerance and augment airway clearance in CF, and it is important that CF providers are comfortable with this therapeutic modality. In this review, we will summarize the physiologic basis for NIV use in CF, describe indications for initiation of NIV, and postulate a practical approach for CF clinicians to take fin monitoring patients on NIV. We will discuss aspects unique to people with CF and the use of NIV. We hope that this serves as a resource for CF providers, especially those of us who do not have dedicated training in sleep medicine, as we continue to care for our patient population.

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Section: Indications For Nivmentioning

confidence: 99%