alexa Non-Invasive Ventilation in the Treatment of Sleep-Related Breathing Disorders: Concise Clinical Review | OMICS International | Abstract
ISSN: 2329-9126

Journal of General Practice
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Review Article

Non-Invasive Ventilation in the Treatment of Sleep-Related Breathing Disorders: Concise Clinical Review

Nicolini Antonello1*Banfi Paolo2Barlascini Cornelius3Ferraioli Gianluca4Lax Agata5Grecchi Bruna3
1Respiratory Diseases Unit, Hospital of Sestri Levante, Italy
2Neuromuscular Diseases Unit, Don Gnocchi Foundation, Milan, USA
3Forensic Medicine, ASL4 Chiavarese, Chiavari, Italy
4Emergency Department, ASL4 Chiavarese, Chiavari, Italy
5Rehabilitation Department, ASL4 Chiavarese, Chiavari, Italy
Corresponding Author : Nicolini Antonello
Respiratory Diseases Unit
Hospital of Sestri Levante
Via Terzi 43, 16039 Sestri Levante, Italy
Tel: 0185-329145
Fax: 0185329935
E-mail: [email protected]
Received April 30, 2013; Accepted June 10, 2013; Published June 15, 2013
Citation: Antonello N, Paolo B, Cornelius B, Gianluca F, Agata L, et al. (2013) Non-Invasive Ventilation in the Treatment of Sleep-Related Breathing Disorders: Concise Clinical Review. J Gen Pract 1:110. doi:10.4172/2329-9126.1000110
Copyright: © 2013 Antonello N, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Abstract

Non-invasive mechanical ventilation (NIV) was originally used in patients with acute respiratory compromises or exacerbations of chronic respiratory diseases, as an alternative to the endotracheal tube. Over the last thirty years NPPV has been also used during the night in patients with stable chronic lung disease such as obstructive sleep apnea, the overlap syndrome (COPD and obstructive sleep apnea), neuromuscular disorders, obesity-hypoventilation syndrome, and in other conditions such as sleep disorders associated with congestive heart failure (Cheyne-Stokes respiration). In this review we discuss the different types of NPPV, the specific conditions in which they can be used and the indications, recommendations and evidence supporting the efficacy of NIV. Obstructive sleep apnea syndrome (OSA) is characterized commonly by instability of upper airway during sleep, reduction or elimination of airflow, daytime hypersomnolence, sleep disruption. It is a risk factor for cardiovascular and cerebrovascular disorders including hypertension, myocardial infarction and stroke. Optimizing patient acceptance and adherence to non-invasive ventilation treatment is challenging. The treatment of sleep-related disorders is a life-threatening condition. The optimal level of treatment should be determinate in a sleep laboratory. Side effects directly affecting the patient’s adherence to treatment are known. The most common are nasopharyngeal symptoms including increased congestion and rhinorrhea; these effects are related to reduced humidity of inspired gas. Humidification of delivered gas may improve these symptoms. Sleep specialists should review the results of objective testing with the patient. Education of the patient concerning the nature of the disorder and treatment options is important. General education on the impact of weight loss, sleep position, alcohol avoidance, risk factor modification and medication effects should be discussed. The patient should be counseled on the risks and management of drowsy driving. Patient education should optimally be delivered as a part of a multidisciplinary chronic disease management team.

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