Sleep related idiopathic non-obstructive alveolar hypoventilation

Several distinct disorders belong to the category “sleep related hypoventilation.” By definition, hypercapnia occurs during sleep but also may extend into wakefulness. The pathogenesis of most is well-known, but less commonly an idiopathic form may occur in obese or even non-obese individuals. Arguably, idiopathic central sleep apnea belongs in this category as well. Pathogenesis is obscure but may involve homeostatic mechanisms responding to abnormal mechanics in obesity, CNS resistance to leptin or other neurohumoral agents or their receptors, or subtle lesions in CNS respiratory control centers. Treatment usually involves non-invasive positive pressure ventilation.