Pulmonary Hemodynamics in Sleep Apnea

  • Jean Krieger
Conference paper


When you consider pulmonary hemodynamics in obstructive sleep apnea, obviously the question is: what is the link between the occurrence of apneas during sleep and the development of what was called the “Pickwickian syndrome”? - that is, a picture of a fat, sleepy patient who has cardiorespiratory failure. This was the question behind the first studies. The early studies which have been performed in this field were reported in a very early paper published in the 1972 report of the Rimini Meeting; Coccagna and coworkers showed that the pulmonary arterial pressure increased during sleep as compared to baseline pulmonary arterial pressure during the awake state. This increase appeared during the obstructive apnea episodes, with a further increase on breathing resumption. They also stressed the very marked oscillations during the obstructive episodes related to the ineffective respiratory episodes.


Obstructive Sleep Apnea Pulmonary Hypertension Sleep Apnea Obstructive Sleep Apnea Syndrome Atrial Natriuretic Peptide 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Bradley T.O., Rutherford R., Grossman R.F., Lue F., Zamel N., Moldofsky H., Phillipson E.A.: Role of daytime hypoxemia in the pathogenesis of right heart failure in the obstructive sleep apnea syndrome. Am Rev Respir Dis (1985) 131: 835–839.PubMedGoogle Scholar
  2. 2.
    Coccagna G., Mantovani M., Brignani F., Parchi C., Lugaresi E.: Continuous recording of the pulmonary and systemic arterial pressure during sleep in syndromes of hypersomnia with periodic breathing. Bull Physiopathol Respir (1972) 8: 1159–1172.Google Scholar
  3. 3.
    Guyton A.C., Lindsey A.W., Abernathy B., Richardson T.: Venous return at various right atrial pressures, and the normal venous return curve. Am J Physiol (1957) 189: 609–615.PubMedGoogle Scholar
  4. 4.
    Krieger J., Follenius M., Sforza E., Brandenberger G., Peter J.D.: Effects of treatment with nasal continuous positive airway pressure on atrial natriuretic peptide and arginine vasopressin release during sleep in obstructive sleep apnea. Clin Sci (1991) 80: 443–449.PubMedGoogle Scholar
  5. 5.
    Krieger J., Laks L., Wilcox I., Grunstein R.R., Costas L.J.V., McDougall J.G., Sullivan C.E.: Atrial natriuretic peptide release during sleep in patients with obstructive sleep apnoea before and during treatment with nasal continuous positive airway pressure. Clin Sci (1989) 77: 407–411.PubMedGoogle Scholar
  6. 6.
    Krieger J., Sforza E., Apprill M., Lampert E., Weitzenblum E., Ratomaharo J.: Pulmonary hypertension, hypoxemia, and hypercapnia in obstructive sleep apnea patients Chest (1989) 96: 729–737.Google Scholar
  7. 7.
    Krieger J., Weitzenblum E: Pulmonary hemodynamics in the obstructive sleep apnea syndrome. In: Sleep and health risk. Eds, Peter J.H., Penzel T., Podszus T., Von Wichert; Springer, Berlin, 1991, pp 356–363.CrossRefGoogle Scholar
  8. 8.
    Krieger J.: Mechanisms of daytime pulmonary hypertension and altered renal function in obstructive sleep apnea. In: Obstructive sleep apnea syndrome. Clinical Research and Treatment. Eds, Guilleminault C., Partinen M. Raven Press, New York, 1990, pp 71–80.Google Scholar
  9. 9.
    Londsdorfer J., Meunier-Carus J., Lampert-Benignus E., et al: Aspects hemodynamiques et respiratoires du syndrome pickwickien. Bull Physiopath Resp (1972) 8: 1181–1192.Google Scholar
  10. 10.
    Marrone O., Bellia U., Ferrara G., Milone F., Romano L, Salvaggio A., Stallone A., Bonsignore G.: Transmural pressure measurements: importance in the assessment of pulmonary hypertension in obstructive sleep apneas. Chest (1989) 95: 338–343.PubMedCrossRefGoogle Scholar
  11. 11.
    Marrone O, Ferrara G., Macaluso C., Milone F., Cibella F., Bellia V., Bonsignore G.: Hemodynamics in obstructive sleep apnea syndrome patients treated by continuous positive airway pressure. In: Sleep related disorders and internal diseases. Eds, Peter J.H., Podszus T., Wichert P. von. Springer, Berlin Heidelberg New York, 1987, pp 375–379.CrossRefGoogle Scholar
  12. 12.
    Schroeder J.S., Motta J., Guilleminault C.: Hemodynamic studies in sleep apnea. In: Sleep apnea syndromes. Eds, Guilleminault C, Dement W.C., Alan R. Liss, New York, 1978, pp 177–196.Google Scholar
  13. 13.
    Weitzenblum E., Krieger J., Apprill M., Vallee E., Erhart M., Ratamaharo J., Oswald M., Kurtz D.: Daytime pulmonary hypertension in patients with obstructive sleep apnea syndrome. Am Rev Respir Dis (1988) 138: 345–349.PubMedGoogle Scholar

Copyright information

© Springer-Verlag Wien 1992

Authors and Affiliations

  • Jean Krieger
    • 1
  1. 1.Clinique NeurologiqueCentre Hospitalier RegionalStrasbourgFrance

Personalised recommendations