Sleep-Disordered Breathing and Idiopathic Normal-Pressure Hydrocephalus: Recent Pathophysiological Advances

Research output: Contribution to journalReview article

Purpose of Review: Idiopathic normal-pressure hydrocephalus (iNPH) is characterized clinically by ventriculomegaly, abnormal gait, falls, incontinence, and cognitive decline. This article reviews recent advances in the pathophysiology of iNPH concerning sleep-disordered breathing (SDB) and glymphatic circulation during deep sleep. Recent Findings: The authors found iNPH frequently associated with obstructive sleep apnea (OSA). A critical factor in iNPH is intracranial venous hypertension delaying drainage of cerebrospinal fluid (CSF) into the cerebral venous sinuses. CSF-venous blood circulates in the jugular veins and finally drains into the heart. During SDB, repeated reflex attempts to breathe induce strong respiratory efforts against a closed glottis thereby increasing the negative intrathoracic pressure. This causes atrial distortion and decreases venous return to the heart resulting in retrograde intracranial venous hypertension. Additionally, repeated awakenings from OSA impede sleep-associated circulation of interstitial CSF into the glymphatic circulation contributing to hydrocephalus. Summary: Sleep has become a critical element in the cognitive changes of aging including iNPH.

Original languageEnglish (US)
Article number39
JournalCurrent Neurology and Neuroscience Reports
Volume19
Issue number7
DOIs
StatePublished - Jul 1 2019

PMID: 31144048

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Sleep-Disordered Breathing and Idiopathic Normal-Pressure Hydrocephalus : Recent Pathophysiological Advances. / Roman, Gustavo C.; Jackson, Robert E.; Fung, Steve H.; Zhang, Y. Jonathan; Verma, Aparajitha.

In: Current Neurology and Neuroscience Reports, Vol. 19, No. 7, 39, 01.07.2019.

Research output: Contribution to journalReview article

Harvard

Roman, GC, Jackson, RE, Fung, SH, Zhang, YJ & Verma, A 2019, 'Sleep-Disordered Breathing and Idiopathic Normal-Pressure Hydrocephalus: Recent Pathophysiological Advances' Current Neurology and Neuroscience Reports, vol. 19, no. 7, 39. https://doi.org/10.1007/s11910-019-0952-9

APA

Roman, G. C., Jackson, R. E., Fung, S. H., Zhang, Y. J., & Verma, A. (2019). Sleep-Disordered Breathing and Idiopathic Normal-Pressure Hydrocephalus: Recent Pathophysiological Advances. Current Neurology and Neuroscience Reports, 19(7), [39]. https://doi.org/10.1007/s11910-019-0952-9

Vancouver

Roman GC, Jackson RE, Fung SH, Zhang YJ, Verma A. Sleep-Disordered Breathing and Idiopathic Normal-Pressure Hydrocephalus: Recent Pathophysiological Advances. Current Neurology and Neuroscience Reports. 2019 Jul 1;19(7). 39. https://doi.org/10.1007/s11910-019-0952-9

Author

Roman, Gustavo C. ; Jackson, Robert E. ; Fung, Steve H. ; Zhang, Y. Jonathan ; Verma, Aparajitha. / Sleep-Disordered Breathing and Idiopathic Normal-Pressure Hydrocephalus : Recent Pathophysiological Advances. In: Current Neurology and Neuroscience Reports. 2019 ; Vol. 19, No. 7.

BibTeX

@article{23818e6eed66422a8146058682412e68,
title = "Sleep-Disordered Breathing and Idiopathic Normal-Pressure Hydrocephalus: Recent Pathophysiological Advances",
abstract = "Purpose of Review: Idiopathic normal-pressure hydrocephalus (iNPH) is characterized clinically by ventriculomegaly, abnormal gait, falls, incontinence, and cognitive decline. This article reviews recent advances in the pathophysiology of iNPH concerning sleep-disordered breathing (SDB) and glymphatic circulation during deep sleep. Recent Findings: The authors found iNPH frequently associated with obstructive sleep apnea (OSA). A critical factor in iNPH is intracranial venous hypertension delaying drainage of cerebrospinal fluid (CSF) into the cerebral venous sinuses. CSF-venous blood circulates in the jugular veins and finally drains into the heart. During SDB, repeated reflex attempts to breathe induce strong respiratory efforts against a closed glottis thereby increasing the negative intrathoracic pressure. This causes atrial distortion and decreases venous return to the heart resulting in retrograde intracranial venous hypertension. Additionally, repeated awakenings from OSA impede sleep-associated circulation of interstitial CSF into the glymphatic circulation contributing to hydrocephalus. Summary: Sleep has become a critical element in the cognitive changes of aging including iNPH.",
keywords = "Cerebral venous circulation, Glymphatic system, Normal-pressure hydrocephalus, Obstructive sleep apnea, Sleep-disordered breathing, Vascular risk factors",
author = "Roman, {Gustavo C.} and Jackson, {Robert E.} and Fung, {Steve H.} and Zhang, {Y. Jonathan} and Aparajitha Verma",
year = "2019",
month = "7",
day = "1",
doi = "10.1007/s11910-019-0952-9",
language = "English (US)",
volume = "19",
journal = "Current neurology and neuroscience reports",
issn = "1528-4042",
publisher = "Current Medicine Group",
number = "7",

}

RIS

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T1 - Sleep-Disordered Breathing and Idiopathic Normal-Pressure Hydrocephalus

T2 - Current neurology and neuroscience reports

AU - Roman, Gustavo C.

AU - Jackson, Robert E.

AU - Fung, Steve H.

AU - Zhang, Y. Jonathan

AU - Verma, Aparajitha

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Purpose of Review: Idiopathic normal-pressure hydrocephalus (iNPH) is characterized clinically by ventriculomegaly, abnormal gait, falls, incontinence, and cognitive decline. This article reviews recent advances in the pathophysiology of iNPH concerning sleep-disordered breathing (SDB) and glymphatic circulation during deep sleep. Recent Findings: The authors found iNPH frequently associated with obstructive sleep apnea (OSA). A critical factor in iNPH is intracranial venous hypertension delaying drainage of cerebrospinal fluid (CSF) into the cerebral venous sinuses. CSF-venous blood circulates in the jugular veins and finally drains into the heart. During SDB, repeated reflex attempts to breathe induce strong respiratory efforts against a closed glottis thereby increasing the negative intrathoracic pressure. This causes atrial distortion and decreases venous return to the heart resulting in retrograde intracranial venous hypertension. Additionally, repeated awakenings from OSA impede sleep-associated circulation of interstitial CSF into the glymphatic circulation contributing to hydrocephalus. Summary: Sleep has become a critical element in the cognitive changes of aging including iNPH.

AB - Purpose of Review: Idiopathic normal-pressure hydrocephalus (iNPH) is characterized clinically by ventriculomegaly, abnormal gait, falls, incontinence, and cognitive decline. This article reviews recent advances in the pathophysiology of iNPH concerning sleep-disordered breathing (SDB) and glymphatic circulation during deep sleep. Recent Findings: The authors found iNPH frequently associated with obstructive sleep apnea (OSA). A critical factor in iNPH is intracranial venous hypertension delaying drainage of cerebrospinal fluid (CSF) into the cerebral venous sinuses. CSF-venous blood circulates in the jugular veins and finally drains into the heart. During SDB, repeated reflex attempts to breathe induce strong respiratory efforts against a closed glottis thereby increasing the negative intrathoracic pressure. This causes atrial distortion and decreases venous return to the heart resulting in retrograde intracranial venous hypertension. Additionally, repeated awakenings from OSA impede sleep-associated circulation of interstitial CSF into the glymphatic circulation contributing to hydrocephalus. Summary: Sleep has become a critical element in the cognitive changes of aging including iNPH.

KW - Cerebral venous circulation

KW - Glymphatic system

KW - Normal-pressure hydrocephalus

KW - Obstructive sleep apnea

KW - Sleep-disordered breathing

KW - Vascular risk factors

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U2 - 10.1007/s11910-019-0952-9

DO - 10.1007/s11910-019-0952-9

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JO - Current neurology and neuroscience reports

JF - Current neurology and neuroscience reports

SN - 1528-4042

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M1 - 39

ER -

ID: 49526694