Sleep-Related Breathing Disorders

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SRBD covers a number of different illnesses which cause alterations in respiratory function, are expressed exclusively during sleep and which are usually related to a reduction in the pharyngeal amplitude.

According to the latest International Classification of Sleep Disorders (ICSD-2) there are four major types of Sleep-Related Breathing Disorders: Central Sleep Apnea Syndromes (CSAS), Obstructive Sleep Apnea/Hypopnea Syndrome (OSAHS), Hypoventilation/Hypoxemia associated with sleep, Undefined/Non-specific sleep disorders. To this list we include Upper Airways Resistance Syndrome (UARS) which many authors consider to be an intermediate stage between Simple Snoring and the development of OSAHS. As snoring is not mentioned in the ICSD-2 as a category it may be mistaken as an symptom and not as an entity itself. From our point of view, after reviewing Sleep-Related Breathing Disorders (SRBD), it is impossible to separate Simple Snoring (SS) from other entities such as UARS or OSAHS.

All the SRBD originate from anatomical and functional alterations of the Upper Airway (UA) which, depending on the severity of clinical manifestations, lead to different pathologies. The more severe forms (UARS and OSAHS) are always preceded by the presence of Simple Snoring.

The most common entity is the OSAHS, which presents as repeated episodes of partial or total cessation of the breathing signal accompanied by respiratory effort and unconscious arousals. Abnormalities in breathing lead to alterations in the normal sleep pattern due to repeated disruptions that cause excessive daytime sleepiness as the most obvious manifestation. Similarly, alterations or interruptions of airflow are linked to serious cardiovascular side effects directly related to the lack of oxygen .