Central sleep apnea due to other medical disorders

Numerous medical disorders can lead to CSA or sleep hypoventilation (Fig. 4). Disorders that affect respiratory control centers or chemoreceptor function can lead to inadequate drive to breathe during sleep when wakefulness neurocompensatory mechanisms are absent. A diminished ability to translate central respiratory drive into adequate ventilation can also be caused by pathologic conditions arising from impairment lower down the neuraxis, including respiratory muscle weakness. Some medical disorders may have dysfunction on multiple levels (see Fig. 4). A bidirectional relationship likely exists for many of these conditions, such that the primary medical disorder causes or worsens the CSA and its adverse effects while the primary medical condition and its associated symptoms are worsened by the CSA. There is a need to explore these relationships and improve the understanding of the underlying mechanisms mediating the link between certain medical conditions and CSA, and the potential to intervene to improve health outcomes.