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Postgraduate Education Corner: CONTEMPORARY REVIEWS IN SLEEP MEDICINE |

Sleep-Related Hypoventilation/Hypoxemic Syndromes*

Kenneth R. Casey, MD, MPH, FCCP; Kathia Ortiz Cantillo, MD; Lee K. Brown, MD, FCCP
Author and Funding Information

*From the Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM.

Correspondence to: Lee K. Brown MD, FCCP, Professor of Medicine and Pediatrics, and Vice Chair, Clinical Program Development, Department of Internal Medicine, University of New Mexico School of Medicine, 1101 Medical Arts Ave NE, Building 2, Albuquerque, NM 87102; e-mail: lkbrown@alum.mit.edu



Chest. 2007;131(6):1936-1948. doi:10.1378/chest.06-2334
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The latest edition of The International Classification of Sleep Disorders: Diagnostic and Coding Manual subsumes a broad range of disorders under the heading “Sleep Related Hypoventilation/Hypoxemic Syndromes.” Some are quite common, such as COPD with worsening gas exchange during sleep; while some are exceedingly rare, such as congenital central hypoventilation syndrome. All share the attribute of abnormal gas exchange that worsens, or may only be present, during sleep. The sleep state, the sleeping posture, and the circadian rhythm driving sleep all may affect respiration by altering control of breathing and/or pulmonary mechanics. These changes are largely inconsequential in the normal individual but interact with respiratory, neurologic, or neuromuscular disease to manifest as the sleep-related hypoventilation/hypoxemic syndromes. In addition to optimal treatment of the underlying disorder (when known and when possible), treatment usually involves nocturnal ventilatory support that is now most commonly provided by noninvasive positive pressure ventilation.


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